| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANTHONIE L GOEDHEER3 | 100 N CORPORATE DRIVE, STE 100 BROOKFIELD, WI 53045 | WPS HEALTH PLAN INC | $40K | — | $40K | 3.66% |
| ANTHONIE L GOEDHEER3 | 100 N CORPORATE DRIVE, STE 100 BROOKFIELD, WI 53045 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORP | $9K | — | $9K | 3.67% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 62689 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.13% |
| AIT SERVICES LLC3 | 840 LAKE STREET EAST SUITE 2 WAYZATA, MN 55391 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 3.50% |
| USI INSURANCE SERVICES LLC3 | 1701 MCFARLAND BLVD N TUSCALOOSA, AL 35406 | STANDARD INSURANCE COMPANY | $407 | — | $407 | 1.27% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.35% |
| AIT SERVICES LLC3 | 840 LAKE STREET EAST SUITE 2 WAYZATA, MN 55391 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 3.50% |
| USI INSURANCE SERVICES LLC3 | 1701 MCFARLAND BLVD N TUSCALOOSA, AL 35406 | STANDARD INSURANCE COMPANY | $379 | — | $379 | 1.29% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | $1K | $498 | $2K | 13.66% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HUMANA DENTAL INSURANCE COMPANY | $4K | — | $4K | 41.47% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | HUMANA DENTAL INSURANCE COMPANY | $7 | — | $7 | 0.08% |
| AIT SERVICES LLC3 | 10405 6TH AVE N, STE 100A PLYMOUTH, MN 55441 | HUMANA DENTAL INSURANCE COMPANY | — | — | $0 | 0.00% |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WPS HEALTH PLAN INC | 148 | $1.1M |
| Dental | HUMANA DENTAL INSURANCE COMPANY | 125 | $9K |
| Vision | HUMANA INSURANCE COMPANY | 106 | $12K |
| Life insurance | STANDARD INSURANCE COMPANY | 161 | $29K |
| Short-term disability | STANDARD INSURANCE COMPANY | 162 | $32K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.