| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | PO BOX 51187 NEW BERLIN, WI 53151 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 5.19% |
| ACRISURE LLC3 | 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | STANDARD INSURANCE COMPANY | $10K | $3K | $13K | 21.59% |
| ACRISURE LLC3 | HNI RISK SERVICES 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | STANDARD INSURANCE COMPANY | $8K | $2K | $9K | 21.27% |
| ACRISURE LLC3 | HNI RISK SERVICES 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | STANDARD INSURANCE COMPANY | $6K | $1K | $7K | 21.31% |
| ACRISURE LLC3 | HNI RISK SERVICES 16805 W CLEVELAND AVE NEW BERLIN, WI 53151 | STANDARD INSURANCE COMPANY | $12K | $2K | $13K | 41.37% |
| ACRISURE LLC3 | PO BOX 51187 NEW BERLIN, WI 53151 | WYSSTA INSURANCE COMPANY INC | $848 | — | $848 | 7.36% |
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 | 212 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 93 | $95K |
| Vision | WYSSTA INSURANCE COMPANY INC | 74 | $12K |
| Life insurance | STANDARD INSURANCE COMPANY | 166 | $60K |
| Short-term disability | STANDARD INSURANCE COMPANY | 82 | $34K |
| Long-term disability | STANDARD INSURANCE COMPANY | 68 | $44K |
| Other | STANDARD INSURANCE COMPANY | 166 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.