| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $41K | — | $41K | 4.63% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $0 | $272 | $272 | 0.03% |
| PAUL CELLA3 Filed as: PAUL J CELLA | KEYARX CAPITAL ADVISORS 101 CRAWFORDS CORNER RD HOLMDEL, NJ 07733 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 3.56% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 S EXECUTIVE DRIVE STE 200 BROOKFIELD, WI 53045 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 2.29% |
| MGIS3 | 111 SOUTH MAIN STREET STE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | $180 | $2K | 2.13% |
| KEYARX CAPITAL ADVISORS3 | 101 CRAWFORDS CORNER RD HOLMDEL, NJ 07733 | SUN LIFE ASSURANCE COMPANY OF CANADA | $875 | — | $875 | 1.00% |
| ACRISURE LLC3 Filed as: ACRISURE | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | SUN LIFE ASSURANCE COMPANY OF CANADA | $823 | $0 | $823 | 0.94% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $7K | — | $7K | 10.35% |
| HNI RISK SERVICES3 Filed as: HNI RISK SERVICES INC. | 16805 WEST CLEVELAND AVENUE NEW BERLIN, WI 53151 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $626 | — | $626 | 8.00% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $156 | — | $156 | 1.99% |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 230 | $883K |
| Dental | DELTA DENTAL OF WISCONSIN | 82 | $64K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 67 | $8K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $88K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $88K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $88K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 82 | $88K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.