| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GUNDERSON HEALTH PLAN, INC.5 | 1836 SOUTH AVENUE NCA 2-01 LA CROSSE, WI 546015429 | HCC LIFE INSURANCE COMPANY | $70K | — | $70K | 23.69% |
| SECURA BROKERAGE LLC3 | 6465 WAYZATA BLVD STE 920 MINNEOAPOLIS, MN 554161709 | METROPOLITAN LIFE INSURANCE COMPANY | $7K | — | $7K | 5.46% |
| BRETT SMITH3 | 201 MAIN STREET SUITE 920 LA CROSSE, WI 546013392 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 3.49% |
| ROGER VANDERMUS3 | 201 MAIN STREET STE 920 LACROSSE, WI 54601 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 2.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| GUNDERSEN LUTHERAN HEALTH PLAN EIN 39-1807071 NONE | Contract Administrator Service code 13 | 3190 GUNDERSON DRIVE ONALASKA, WI 54650 | $70K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Contract Administrator; Insurance agents and brokers Service code 13 | 2801 HOOVER ROAD P.O. BOX 828 STEVENS POINT, WI 544817100 | $6K |
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 | 197 | 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) | 197 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 197 | $129K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 197 | $129K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 197 | $129K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 447 | $296K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 197 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.