| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR STE 100 MOUNT PLEASANT, WI 53406 | UNITEDHEALTHCARE INSURANCE COMPANY | $11K | — | $11K | 1.66% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR STE 100 MOUNT PLEASANT, WI 53406 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 0.58% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE | 160 FEDERAL ST 2ND FLOOR BOSTON, MA 02110 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $2K | $2K | 0.26% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST #291 RACINE, WI 53403 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $1K | $1K | 0.21% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 7.13% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | — | $3K | 14.55% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.72% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | WYSSTA INSURANCE COMPANY INC | $583 | — | $583 | 8.06% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $45 | — | $45 | 15.00% |
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 | 112 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 122 | $686K |
| Dental | DELTA DENTAL OF WISCONSIN | 78 | $62K |
| Vision | WYSSTA INSURANCE COMPANY INC | 64 | $7K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 156 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 154 | $23K |
| Other(4 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 156 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 156 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.