| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST., STE. 21 RACINE, WI 53403 | SECURITY HEALTH PLAN OF WISCONSIN, INC. | $14K | — | $14K | 1.39% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DR. MOUNT PLEASANT, WI 53406 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 6.09% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR. MOUNT PLEASANT, WI 53406 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.80% |
| JOHNSON INS SERVICES LLC3 Filed as: JOHNSON INS SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | UNION SECURITY INSURANCE COMPANY | $1K | $557 | $2K | 8.99% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE GROUP, INC | N27 W23953 PAUL RD., STE 200 PEWAUKEE, WI 53072 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 8.98% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INS. GROUP, INC. | PO BOX 207 MOSINEE, WI 59455 | UNION SECURITY INSURANCE COMPANY | $1K | — | $1K | 7.75% |
| JOHNSON INS SERVICES LLC3 Filed as: JOHNSON INS. SERVICES LLC | 318 S. WASHINGTON ST., STE 200 GREEN BAY, WI 54301 | UNION SECURITY INSURANCE COMPANY | $819 | — | $819 | 5.17% |
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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 169 | $1.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 100 | $66K |
| Life insurance | STANDARD INSURANCE COMPANY | 185 | $28K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 44 | $19K |
| Prescription drug | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 169 | $1.0M |
| Other | UNION SECURITY INSURANCE COMPANY | 58 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 185 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.