| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $61K | — | $61K | 12.66% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 5.03% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $237 | $237 | 0.39% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 9.09% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $190 | $190 | 0.39% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.66% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 10.88% |
| CENTRO BENEFITS RESEARCH LLC3 | 325 N. KIRKWOOD ROAD STE 300 KIRKWOOD, MO 63122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $57 | $57 | 0.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS & BLUE SHIELD EIN 39-0138065 CLAIMS PROCESSING | Other services; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $33K |
| COMPCARE HEALTH SERVICES INSURANCE EIN 39-1462554 CLAIMS PROCESSING | Claims processing; Contract Administrator; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $22K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $11K |
| MCCLONE INS AGENT OR BROKER | Insurance agents and brokers Service code 22 | PO BOX 389 MENASHA, WI 54952 | $7K |
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 | 296 | 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) | 296 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 124 | $17K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 296 | $14K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 261 | $61K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 273 | $49K |
| Stop-loss / reinsurancereinsurance | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 285 | $478K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 296 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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.