| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $25K | $25K | 3.09% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 549520389 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 7.19% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 13.87% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE INSURANCE GROUP | PO BOX 389 MENASHA, WI 54952 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 18.95% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 25.00% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 25.00% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | 150 MAIN STREET SUITE 102 MENASHA, WI 54952 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $1K | — | $1K | 9.94% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 54952 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $629 | — | $629 | 14.76% |
| GERALD FRANZEN3 | W15385 HUTCHWOOD ROAD ANTIGO, WI 54409 | AFLAC | $57 | — | $57 | 2.34% |
| MAUREEN A SETHER3 Filed as: MAUREEN SETHER | 941 S WEST COURT UNIT D APPLETON, WI 54915 | AFLAC | $39 | — | $39 | 1.60% |
| JOSEPH P VOZKA3 Filed as: JOSEPH VOZKA | N6715 COUNTY ROAD V DEERBROOK, WI 54424 | AFLAC | $35 | — | $35 | 1.44% |
| CHRIS ZELLNER3 | 918 ALDORA LN STE 106 WAUNAKEE, WI 53597 | AFLAC | $20 | — | $20 | 0.82% |
| MICHAEL E MCCARTHY3 Filed as: MICHAEL MCCARTHY | PO BOX 1047 DUNDEE, IL 60118 | AFLAC | $14 | — | $14 | 0.58% |
| GLEN T SCHWEIKERT3 Filed as: GLEN SCHWEIKERT | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $5 | — | $5 | 0.21% |
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 | 122 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 268 | $825K |
| Dental | DELTA DENTAL OF WISCONSIN | 72 | $61K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 135 | $11K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 150 | $21K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 57 | $15K |
| Other(4 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 150 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 268 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.