| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 11 PORT WASHINGTON, WI 53074 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN | $2K | — | $2K | 10.00% |
| ANSAY & ASSOCIATES LLC3 | STEVE KLEBER 101 E GRAND AVE PORT WASHINGTON, WI 53074 | DELTA DENTAL OF WISCONSIN | $121 | $10K | $10K | — |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 203 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SUN LIFE ASSURANCE COMPANY OF CANADA | 213 | $443K |
| Dental | DELTA DENTAL OF WISCONSIN | 216 | $0 |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN | 210 | $24K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 231 | $52K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 231 | $52K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 231 | $520K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.