| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE CENTER3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $20K | — | $20K | 1.31% |
| COTTINGHAM & BUTLER3 | 800 MAIN STREET DUBUQUE, IA 52001 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $6K | — | $6K | 0.41% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 3.36% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | SELECTHEALTH | $5K | — | $5K | 5.38% |
| COTTINGHAM & BUTLER3 | 300 SECURITY BUILDING DUBUQUE, IA 52001 | DELTA DENTAL OF WISCONSIN | $7K | — | $7K | 9.24% |
| T I C INC3 Filed as: T.I.C. INC | 701 SAND LAKE ROAD ONALASKA, WI 54650 | SELECTHEALTH | $3K | — | $3K | 3.65% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 6.84% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 16.40% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 16.49% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6K | — | $6K | 19.36% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 6.38% |
| TIC INC3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | STANDARD INSURANCE COMPANY | $401 | — | $401 | 1.50% |
| ADVANTAGE GROUP GA LLC3 | 510 ALDERSON STREET SCHOFIELD, WI 54476 | TRANSAMERICA | $168 | — | $168 | 2.79% |
| ANTHONY K ROACH3 | 815 OFFICE PARK ROAD SUITE 7 WEST DES MOINES, IA 50265 | TRANSAMERICA | $77 | — | $77 | 1.28% |
| BENEFIT ADVISORS INSURANCE AGENCY3 | 560 LESTER AVENUE ONALASKA, WI 54650 | TRANSAMERICA | $48 | — | $48 | 0.80% |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 220 | $1.7M |
| Dental(3 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 169 | $106K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 217 | $33K |
| Short-term disability(2 contracts) | STANDARD INSURANCE COMPANY | 151 | $149K |
| Long-term disability(2 contracts) | STANDARD INSURANCE COMPANY | 105 | $89K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 220 | $1.5M |
| Other(6 contracts, 3 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 225 | $148K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 225 | — |
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.