| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHWARZ INSURANCE3 | 1420 NORTH RIDGE DRIVE PRAIRIE DU SAC, WI 53578 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | $18K | $3K | $20K | 17.36% |
| GROUP INSURANCE SERVICES INC3 Filed as: GROUP INSURANCE SERVICES, INC. | 1607 N AURORA RD #201 NAPERVILLE, IL 60563 | DEARBORN NATIONAL LIFE INSURANCE COMPANY | — | $7K | $7K | 5.81% |
| AON CONSULTING INC3 Filed as: CUSTOM BEN. PROGRAMS & AON COMPANY | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $472 | $185 | $657 | 4.09% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY INC. | 1420 N. RIDGE DR. PRAIRIE DU SAC, WI 53578 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $622 | — | $622 | 3.88% |
| WIS. MED. SOCIETY INS & FINANCIAL S3 | PO BOX 1109 MADISON, WI 53701 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $216 | — | $216 | 1.35% |
No Schedule C service providers reported on this filing.
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 | 542 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 542 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 545 | $133K |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY | 545 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 545 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.