| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHWARZ INSURANCE3 | 1420 NORTH RIDGE DRIVE PRAIRIE DU SAC, WI 53578 | AMERICAN FIDELITY | $103K | — | $103K | 12.35% |
| AUXIANT3 | 2450 RIMROCK RD MADISON, WI 53713 | AMERICAN FIDELITY | $44K | — | $44K | 5.29% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $42K | $11K | $53K | 18.90% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14K | $6K | $20K | 7.08% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $28K | $7K | $35K | 18.94% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $4K | $13K | 7.11% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14K | $3K | $17K | 18.77% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $2K | $6K | 7.00% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY, INC | 1420 NORTH RIDGE DR., P.O. BOX 40 PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD | $4K | — | $4K | 8.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | PO BOX 9201, BLDG I SUITE 100 AUSTIN, TX 78766 | RELIANCE STANDARD | $0 | $3K | $3K | 5.00% |
| GROUP INSURANCE SERVICES INC3 | PO BOX 901 NAPERVILLE, IL 60566 | RELIANCE STANDARD | $3K | — | $3K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $15K | — | $15K | 47.00% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $3K | $9K | 28.00% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $1K | $6K | 19.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IA 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $665 | $2K | 7.13% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 47.00% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $929 | $4K | 23.00% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $309 | $2K | 18.51% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $441 | $165 | $606 | 6.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AUXIANT CLAIMS PROCESING | Contract Administrator; Claims processing Service code 12 | 2450 RIMROCK RD MADISON, WI 53713 | $208K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $19K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $8K |
| SCHWARZ INSURANCE INS AGENT OR BROKER | Insurance agents and brokers Service code 22 | 1420 N RIDGE DR PRAIRIE DU SAC, WI 53578 | $3K |
Benefits declared on the Form 5500 main form (✓ = also has a Schedule A insurance contract; otherwise the benefit is funded out of plan assets or via a Schedule C TPA).
The plan reports several different headcounts depending on which form you read. Each one measures a different slice of the population.
| Active participants | 405 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 416 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | RELIANCE STANDARD | 322 | $56K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 517 | $124K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 518 | $186K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 519 | $279K |
| Stop-loss / reinsurancereinsurance | AMERICAN FIDELITY | 405 | $834K |
| Other(6 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 610 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 610 | — |
Why the numbers differ. Form 5500 line 6 counts employees + retirees + beneficiaries; no dependents. Schedule A persons-covered counts everyone enrolled, including spouses and children, so it usually exceeds line 6 by 30-60% on a working-age workforce. The medical row is normally the broadest single line because it has the highest take-up; dental/vision/life often dip below it. Stop-loss / reinsurance contracts sometimes report the carrier's full underwriting pool rather than this filer's headcount; the row is shown for transparency but shouldn't be read as "people in this plan."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.