| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSURANCE AGENCY LTD3 Filed as: SUN LIFE ASSURANCE COMPANY OF CANAD | ONE SUN LIFE EXECUTIVE PARK WEILLESLEY HILLS, MA 02481 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | — | $0 | 0.00% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | DELTA DENTAL OF WISCONSIN | $7K | — | $7K | 9.72% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 17.89% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC DBA THE INSURANCE C | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $469 | $2K | 4.62% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | WYSSTA INSURANCE COMPANY INC. | $887 | — | $887 | 8.69% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $784 | — | $784 | 15.00% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $699 | — | $699 | 15.00% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $422 | — | $422 | 14.99% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 128 | $72K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 100 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 91 | $50K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 70 | $5K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 118 | $318K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 173 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.