| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 555 MAIN STREET STE 320 RACINE, WI 53403 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION (GO423) | $4K | — | $4K | 0.47% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES,LLC | 1111 COMMERCE DRIVE RACINE, WI 53406 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $1K | — | $1K | 0.47% |
| JASON LETTENBERGER3 | 9000 W CHESTER ST STE 100 MILWAUKEE, WI 53214 | RELIANCE STANDARD | $4K | $1K | $5K | 19.00% |
| MICHAEL UMSCHEID3 | 3206 MARKET LANE APT 609 KENOSHA, WI 53144 | RELIANCE STANDARD | $4K | — | $4K | 15.00% |
| JASON LETTENBERGER3 | 9000 W CHESTER STRET STE 100 MILWAUKEE, WI 53214 | RELIANCE STANDARD | $2K | $561 | $2K | 16.50% |
| MICHAEL UMSCHIEDL3 | 3206.MARKET LANE APT 609 KENOSHA, IL 60450 | RELIANCE STANDARD | $2K | $0 | $2K | 12.50% |
| MICHAEL UMSCHEID3 | 9000 W. CHESTER ST STE 100 MILWAUKEE, WI 53214 | COMPANION LIFE | $562 | $10 | $572 | 6.71% |
| JASON LETTENBERGER3 | N19 W24 RIVERWOOD DRIVE STE 140 WAUKESHA, WI 53188 | COMPANION LIFE | $551 | — | $551 | 6.46% |
| MICHAEL UMSCHEID3 | 9000 W CHESTER STREET STE 100 MILWAUKEE, WI 53214 | COMPANION LIFE | $533 | $10 | $543 | 6.83% |
| JASON LETTENBERGER3 | N19 W24 200 RIVERWOOD DRIVE STE 140 WAUKESHA, WI 53188 | COMPANION LIFE | $523 | — | $523 | 6.57% |
| MICHAEL UMSCHEID3 | 3206 MARKET LANE APT 609 KENOSHA, WI 53144 | RELIANCE STANDARD | $922 | — | $922 | 12.50% |
| JASON LETTENBERGER3 | 9000 W CHESTER ST STE 100 MILWAUKEE, WI 53214 | RELIANCE STANDARD | $922 | — | $922 | 12.50% |
| JASON LETTENBERGER3 | 9000 W CHESTER ST STE 100 MILWAUKEE, WI 53214 | RELIANCE STANDARD | $667 | $267 | $934 | 14.00% |
| MICHAEL UMSCHEID3 | 3206 MARKET LANE APT 609 KENOSHA, WI 53144 | RELIANCE STANDARD | $667 | — | $667 | 10.00% |
| MICHAEL UMSCHEID3 Filed as: MICHAEL UMSCHIED | 9000 W CHESTER STREET STE 100 MILWAUKEE, WI 53214 | COMPANION LIFE | $378 | $10 | $388 | 7.72% |
| JASON LETTENBERGER3 | N19 W24 200 RIVERWOOD DRIVE STE 140 WAUKESHA, WI 53188 | COMPANION LIFE | $367 | — | $367 | 7.30% |
| JASON LETTENBERGER3 | 9000 W CHESTER ST STE 100 MILWAUKEE, WI 53214 | RELIANCE STANDARD | $141 | $113 | $254 | 8.98% |
| MICHAEL UMSCHEID3 | 3206 MARKET LANE APT 609 KENOSHA, WI 53144 | RELIANCE STANDARD | $141 | — | $141 | 4.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DIVERSIFIED BENEFIT SERVICES, INC EIN 39-1695622 CLAIMS PROCESSOR | Claims processing; Plan Administrator Service code 12 | 625 WALNUT RIDGE DRIVE 190 HARTLAND, WI 53029 | $3K |
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 | 242 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION (GO423) | 184 | $1.1M |
| Life insurance | RELIANCE STANDARD | 65 | $27K |
| Short-term disability(3 contracts) | COMPANION LIFE | 23 | $22K |
| Long-term disability(2 contracts) | RELIANCE STANDARD | 59 | $21K |
| Other(3 contracts) | RELIANCE STANDARD | 65 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 184 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.