| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE INC | 700 REGENT ST #400 MADISON, WI 53715 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $27K | $0 | $27K | 1.13% |
| BUCCHOLZ PLANNING CORPORATION3 | 120 E LAKESIDE ST STE 260 MADISON, WI 53715 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | MAIL STOP 072103 MADISON PO BOX 4134 CLINTON, IA 527334134 | HARTFORD LIFE AND ACCIDENT | $12K | $2K | $14K | 17.77% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 1.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | MAIL STOP 072103 MADISON PO BOX 4134 CLINTON, IA 527334134 | HARTFORD LIFE AND ACCIDENT | $7K | $2K | $9K | 12.78% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | — | $1K | $1K | 1.55% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | STE 112 7818 BIG SKY DR MADISON, WI 53719 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | MAIL STOP 072103 MADISON PO BOX 4134 CLINTON, IA 527334134 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | — | $199 | $199 | 1.49% |
| HAUSMANN-JOHNSON INSURANCE INC3 | 740 REGENT ST STE 400 MADISON, WI 537152650 | VISION SERVICE PLAN | $867 | $0 | $867 | 6.49% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | MAIL STOP 072103 MADISON PO BOX 4134 CLINTON, IA 527334134 | HARTFORD LIFE AND ACCIDENT | $745 | $0 | $745 | 14.99% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 95287 CHICAGO, IL 60694 | HARTFORD LIFE AND ACCIDENT | — | $70 | $70 | 1.41% |
| BUCHHOLZ PLANNING CORPORATION3 | 120 E LAKESIDE ST STE 260 MADISON, WI 53715 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $849 | — | $849 | 27.06% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 537159408 | DELTA DENTAL OF WISCONSIN | $572 | $0 | $572 | — |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 145 | $0 |
| Vision | VISION SERVICE PLAN | 116 | $13K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 194 | $77K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 195 | $71K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 330 | $2.4M |
| Other(6 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 230 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 330 | — |
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.