| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHWARZ INSURANCE3 | 1420 NORTH RIDGE DRIVE PRAIRIE DU SAC, WI 53578 | QBE INSURANCE | $104K | — | $104K | 8.51% |
| AUXIANT3 | 2450 RIMROCK RD MADISON, WI 53713 | QBE INSURANCE | $45K | — | $45K | 3.67% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $40K | $4K | $44K | 16.58% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | — | $13K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $3K | $3K | 1.05% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 535781096 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $26K | $3K | $29K | 16.61% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 1.07% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 535781096 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | $1K | $15K | 16.56% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $924 | $924 | 1.04% |
| HOME OFFICE TPA PAYS COMMISSION3 Filed as: HOME OFFICE TPA PAYS COMMUSSION | 475 FALLBROOK BLVD LINCOLN, NE 685219033 | RELIANCE STANDARD | $7K | — | $7K | 13.00% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $385 | $3K | $4K | 11.94% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $897 | — | $897 | 2.80% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $632 | $632 | 1.97% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $467 | $5K | 16.61% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS INC. | 422 WAUPONSEE STREET MORRIS, IA 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $312 | $312 | 1.08% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $248 | $1K | $1K | 6.88% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 5.00% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $577 | — | $577 | 2.80% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $372 | $372 | 1.80% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $132 | $1K | 16.53% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $429 | — | $429 | 4.99% |
| GIS BENEFITS INC3 Filed as: GIS | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $88 | $88 | 1.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AUXIANT CLAIMS PROCESING | Claims processing; Contract Administrator Service code 12 | 2450 RIMROCK RD MADISON, WI 53713 | $230K |
| HEALTHCHECK360 EIN 42-1403200 WELLNESS PLAN VENDOR | Employee (plan sponsor) Service code 35 | 800 MAIN STREET DUBUQUE, IA 52003 | $122K |
| 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 | 402 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 413 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | RELIANCE STANDARD | 318 | $51K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 505 | $118K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 505 | $174K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 505 | $265K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE | 403 | $1.2M |
| Other(6 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 622 | $191K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 622 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.