| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF WISCONSIN, INC. | 1200 NORTH MAYFAIR ROAD, SUITE 100 MILWAUKEE, WI 53226 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $17K | — | $17K | 0.63% |
| WALLACE COOPER & ELLIOT INS. AGENCY3 | 197 SOUTH MAIN STREET RICHLAND CENTER, WI 53581 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $6K | — | $6K | 0.24% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $3K | — | $3K | 0.10% |
| ROGER VANDERMUS3 | 2941 WILD ROSE LANE ONALASKA, WI 54650 | USABLE LIFE | $22K | — | $22K | 15.16% |
| BENEUSA LLC3 Filed as: BENEUSA, LLC | 261 SCHOOL AVENUE, SUITE 350 EXCELSIOR, MN 55331 | USABLE LIFE | $7K | — | $7K | 5.05% |
| BRETT GEORGE SMITH3 | 501 EAST MCBEE AVENUE GREENVILLE, SC 29601 | NORTHWESTERN MUTUAL | $2K | $606 | $3K | 5.83% |
| JON B. TRIPOLI3 | 501 EAST MCBEE AVENUE GREENVILLE, SC 29601 | NORTHWESTERN MUTUAL | $2K | $606 | $3K | 5.83% |
| RICHARD WORRELL LLC3 Filed as: RICHARD WORRELL, LLC | 6235 CARNEGIE BOULEVARD CHARLOTTE, NC 28211 | NORTHWESTERN MUTUAL | $961 | $173 | $1K | 2.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN FLORIDA, INC. | 300 NORTH BEACH STREET DAYTONA BEACH, FL 32114 | NGL | $1K | — | $1K | 4.84% |
| HAYS COMPANIES, INC.3 | 1200 NORTH MAYFAIR ROAD, SUITE 100 MILWAUKEE, WI 53226 | NGL | $1K | — | $1K | 4.33% |
| WALLACE COOPER & ELLIOT INS. AGENCY3 | 197 SOUTH MAIN STREET RICHLAND CENTER, WI 53581 | NGL | $196 | — | $196 | 0.83% |
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 | 188 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 301 | $2.6M |
| Dental | DELTA DENTAL OF WISCONSIN | 134 | $109K |
| Vision | NGL | 174 | $24K |
| Life insurance | USABLE LIFE | 188 | $145K |
| Short-term disability | USABLE LIFE | 188 | $145K |
| Long-term disability | NORTHWESTERN MUTUAL | 186 | $52K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 301 | $2.6M |
| Other | USABLE LIFE | 188 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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."
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.