| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STACEY ROBERTSON3 | 888 STATE HIGHWAY 153 STE 200 MOSINEE, WI 54455 | ASPIRUS HEALTH PLAN | $15K | — | $15K | 2.14% |
| STACEY ROBERTSON3 | 888 STATE HIGHWAY 153 STE 200 MOSINEE, WI 54455 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $5K | — | $5K | 1.82% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 5.23% |
| ANSAY & ASSOCIATES LLC3 | 1710 LAWRENCE DR STE 100 DE PERE, WI 54115 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $52 | $52 | 0.11% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53704 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 13.01% |
| ANSAY & ASSOCIATES LLC3 | 1710 LAWRENCE DR STE 100 DE PERE, WI 54115 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $59 | $59 | 0.24% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ANSAY & ASSOCIATES LLC3 | 1710 LAWRENCE DR STE 100 DE PERE, WI 54115 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $59 | $59 | 0.24% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
| ANSAY & ASSOCIATES LLC3 | 1710 LAWRENCE DR STE 100 DE PERE, WI 54115 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $50 | $50 | 0.24% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $69 | — | $69 | 0.91% |
| ANSAY & ASSOCIATES LLC3 | 1710 LAWRENCE DR STE 100 DE PERE, WI 54115 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $18 | $18 | 0.24% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $322 | — | $322 | 10.00% |
| ANSAY & ASSOCIATES LLC3 | 1710 LAWRENCE DR STE 100 DE PERE, WI 54115 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $8 | $8 | 0.25% |
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 | 170 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ASPIRUS HEALTH PLAN | 135 | $966K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 79 | $46K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 61 | $8K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $3K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 127 | $24K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 161 | $25K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $24K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.