| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 54952 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $33K | $33K | 3.09% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 549520389 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 7.25% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | 150 MAIN ST STE 300 MENASHA, WI 549523386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $214 | $4K | 21.19% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $569 | $569 | 3.17% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 54952 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 15.36% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | 150 MAIN ST STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $137 | $2K | 15.71% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $364 | $364 | 2.35% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $412 | $412 | 2.67% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | 150 MAIN ST. STE 300 MENASHA, WI 549523386 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $155 | $155 | 1.00% |
| 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 | 10.48% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | 150 MAIN ST STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $737 | $141 | $878 | 11.92% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $376 | $376 | 5.10% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | 150 MAIN ST STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $410 | $38 | $448 | 10.93% |
| PROSENTIAL BENEFITS LLC3 | 40 TIOGA WAY STE 230 MARBLEHEAD, MA 01945 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $100 | $100 | 2.44% |
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 | 121 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 259 | $1.1M |
| Dental | DELTA DENTAL OF WISCONSIN | 75 | $63K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 135 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 146 | $22K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 71 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 56 | $16K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 60 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.