| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALLACE COOPER & ELLIOT INS. AGENCY3 Filed as: WALLACE COOPER & ELLIOT INS AGENCY | 197 S MAIN ST PO BOX 470 RICHLAND CENTER, WI 53581 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $26K | — | $26K | 1.00% |
| VANDERMUS, ROGER3 | 2941 WILD ROSE LANE ONALASKA, WI 54650 | USABLE LIFE | $19K | — | $19K | 15.00% |
| BENEUSA LLC3 | 261 SCHOOL AVE STE 350 EXCELSIOR, MN 55331 | USABLE LIFE | $6K | — | $6K | 5.00% |
| BRETT GEORGE SMITH3 | 501 E MCBEE AVE GREENVILLE, SC 29601 | NORTHWESTERN MUTUAL | $2K | $620 | $3K | 4.87% |
| JOHN D TYLER3 Filed as: JOHN B TRIPOLI | 501 E MCBEE AVE GREENVILLE, SC 29601 | NORTHWESTERN MUTUAL | $2K | $620 | $3K | 4.87% |
| RICHARD WORRELL LLC3 | 6235 MORRISON BLVD CHARLOTTE, NC 28211 | NORTHWESTERN MUTUAL | $713 | $86 | $799 | 1.30% |
| RICHARD WORRELL LLC3 | 6235 MORRISON BLVD CHARLOTTE, NC 28211 | NORTHWESTERN MUTUAL | $238 | $85 | $323 | 0.52% |
| WALLACE COOPER & ELLIOT INS. AGENCY3 Filed as: WALLACE, COOPER & ELLIOT INSURANCE | AGENCY INC. 197 S. MAIN ST PO BOX 470 RICHLAND CENTER, WI 53581 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $3K | — | $3K | 10.00% |
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 | 396 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 406 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 162 | $125K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 229 | $26K |
| Life insurance | USABLE LIFE | 234 | $123K |
| Short-term disability | USABLE LIFE | 234 | $123K |
| Long-term disability | NORTHWESTERN MUTUAL | 267 | $62K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 396 | $2.6M |
| Other | USABLE LIFE | 234 | $123K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 396 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.