| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VIZANCE, INC.3 Filed as: VIZANCE BENEFITS, LLC | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED HEALTHCARE INSURANCE COMPANY | $42K | $0 | $42K | 3.09% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: BENEFIT ALLIANT, LLC | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $5K | $5K | 0.36% |
| VIZANCE, INC.3 Filed as: VIZANCE INC. | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $866 | $3K | 21.08% |
| VIZANCE, INC.3 Filed as: VIZANCE BENEFITS, LLC | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | WYSSTA INSURANCE COMPANY | $786 | $0 | $786 | 8.53% |
| VIZANCE, INC.3 Filed as: VIZANCE INC. | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $635 | $376 | $1K | 15.93% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD-PARTY ADMIN (TPA) | Contract Administrator Service code 13 | 3100 BUSINESS PARK DRIVE STEVENS POINT, WI 54481 | $6K |
| VIZANCE BENEFITS, LLC EIN 39-2040532 BROKER | Insurance agents and brokers Service code 22 | 1320 WALNUT RIDGE DRIVE SUITE 200 HARTLAND, WI 53029 | $2K |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 151 | $1.4M |
| Vision | WYSSTA INSURANCE COMPANY | 86 | $9K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $6K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 116 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.