| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE CENTER3 | 701 SAND LAKE RD ONALASKA, WI 546502442 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $4K | — | $4K | 2.24% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 18.90% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $551 | $551 | 2.62% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $959 | $3K | 15.50% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $479 | $479 | 2.75% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $738 | $3K | 19.68% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $369 | $369 | 2.34% |
| T I C INC3 Filed as: T.I.C., INC. | 701 SAND LAKE RD ONALASKA, WI 546502442 | DELTA DENTAL OF WISCONSIN | $679 | — | $679 | 6.07% |
| T I C INC3 Filed as: T.I.C., INC. | 701 SAND LAKE RD ONALASKA, WI 546502442 | WYSSTA INSURANCE COMPANY INC | $469 | — | $469 | 7.99% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $427 | $229 | $656 | 15.35% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $114 | $114 | 2.67% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $506 | — | $506 | 23.19% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $334 | — | $334 | 18.67% |
| T I C INC3 Filed as: T.I.C., INC. | 701 SAND LAKE RD ONALASKA, WI 546502442 | WYSSTA INSURANCE COMPANY INC | $116 | — | $116 | 8.00% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $312 | — | $312 | 23.83% |
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 | 128 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 131 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 87 | $160K |
| Vision(3 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 62 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $4K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 110 | $21K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 87 | $160K |
| Other(7 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 141 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 141 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.