| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUMANA MARKETPOINT INC5 Filed as: HUMANA | — | HUMANA HEALTH PLAN, INC. | — | $323K | $323K | 28.83% |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 549520389 | HUMANA HEALTH PLAN, INC. | $117K | $4K | $121K | 10.82% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY, INC. | PO BOX 389 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $26K | $26K | $52K | 8.56% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 501 OFFICE CENTER DR. STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $11K | $11K | 1.88% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE INSURANCE, INC. | 150 MAIN STREET MENASHA, WI 54952 | CARE PLUS DENTAL PLANS, INC. | $9K | — | $9K | 6.00% |
| MCCLONE AGENCY INC3 | 150 MAIN STREET SUITE 300 MENASHA, WI 54952 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $14K | — | $14K | 9.81% |
| DELTA DENTAL OF WISCONSIN5 | PO BOX 828 STEVENS POINT, WI 54481 | DELTA DENTAL OF WISCONSIN | — | $32K | $32K | — |
| MCCLONE AGENCY INC3 | PO BOX 389 MENASHA, WI 549520389 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | — |
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 | 1,022 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,042 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA HEALTH PLAN, INC. | 1,038 | $1.1M |
| Dental(2 contracts, 2 carriers) | CARE PLUS DENTAL PLANS, INC. | 783 | $155K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 1,182 | $138K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,727 | $611K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,727 | $611K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,727 | $611K |
| Stop-loss / reinsurancereinsurance | HUMANA HEALTH PLAN, INC. | 1,038 | $1.1M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,727 | $611K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,727 | — |
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.