| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RSC INSURANCE BROKERAGE INC3 | 1103 HUNTER DR. MOUNT PLEASANT, WI 53406 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 5.97% |
| MIDWEST SELECT INSURANCE GROUP LLC3 | N27 W23953 PAUL RD., STE 200 PEWAUKEE, WI 53072 | COMPANION LIFE | $10K | — | $10K | 22.42% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE GROUP | N27 W23953 PAUL RD SUITE 200 PEWAUKEE, WI 53072 | COMPANION LIFE | $8K | — | $8K | 22.91% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR. MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.12% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE GROUP | 1101 W. CLAIREMONT AVE., STE. 2E EAU CLAIRE, WA 54701 | ASSURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 18.11% |
| SCS BENEFIT SERVICES LLC3 | — | ASSURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 8.94% |
| CURTIS LARSON3 Filed as: CURTIS DEPREY | — | ASSURITY LIFE INSURANCE COMPANY | $33 | — | $33 | 0.28% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INS. GROUP, INC. | 1101 W. CLAIREMONT AVE., STE. 2E EAU CLAIRE, WI 54701 | ASSURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 21.84% |
| SCS BENEFIT SERVICES LLC3 | — | ASSURITY LIFE INSURANCE COMPANY | $795 | — | $795 | 9.26% |
| CURTIS LARSON3 Filed as: CURTIS DEPREY | — | ASSURITY LIFE INSURANCE COMPANY | $24 | — | $24 | 0.28% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE GROUP | N27 W23953 PAUL RD SUITE 200 PEWAUKEE, WI 53072 | COMPANION LIFE | $803 | — | $803 | 22.73% |
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 | 282 | 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) | 286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 132 | $78K |
| Vision | WYSSTA INSURANCE COMPANY INC | 117 | $12K |
| Life insurance(3 contracts) | COMPANION LIFE | 129 | $83K |
| Short-term disability(3 contracts) | COMPANION LIFE | 129 | $83K |
| Long-term disability(3 contracts) | COMPANION LIFE | 129 | $83K |
| Other(5 contracts, 2 carriers) | COMPANION LIFE | 129 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.