| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | SUN LIFE ASSURANCE COMPANY OF CANADA | $26K | — | $26K | 5.12% |
| UMR, INC.3 | 11 SCOTT ST STE 100 WAUSAU, WI 54403 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $4K | $4K | 0.77% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 1133 WESTCHESTER AVE STE S229 WHITE PLAINS, NY 10604 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 0.23% |
| JEFFREY A GENTZ3 | 8918 29TH CT KENOSH, WI 53143 | AFLAC | $5K | — | $5K | 10.76% |
| KRISTINE A PEREZ3 | PO BOX 673 GENOA CITY, WI 53128 | AFLAC | $715 | $109 | $824 | 1.62% |
| KENNETH J HOFFMAN3 | N65W13544 COBBLESTONE CT MENOMONEE FALLS, WI 53227 | AFLAC | $669 | $4 | $673 | 1.32% |
| THE WICHMANN GROUP INC3 Filed as: THE WICHMANN GROUP, INC. | 12207 S 210TH ST GRETINA, NE 68028 | AFLAC | $435 | — | $435 | 0.86% |
| JACK D BREES3 | 2989 S WAUKESHA RD WEST ALLIS, WI 53227 | AFLAC | $435 | — | $435 | 0.86% |
| KARA SUE STADEL3 | 4049 N RAWLINS RD GALENA, IL 61036 | AFLAC | $180 | — | $180 | 0.35% |
| JOSEPH P HOFFMAN3 | 601 N THORNBUSH CIR HARTLAND, WI 53029 | AFLAC | $108 | $5 | $113 | 0.22% |
| PATRICIA MELL3 | 25858 JULIE CT PLAINFIELD, IL 60585 | AFLAC | $112 | — | $112 | 0.22% |
| JARED J BUCK3 | 133 W OREGON ST APT 210 MILWAUKEE, WI 53204 | AFLAC | $65 | $13 | $78 | 0.15% |
| HOLLY A MARITA3 | 4623 HARDING RD KENOSHA, WI 53142 | AFLAC | $64 | — | $64 | 0.13% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $56 | — | $56 | 0.11% |
| GARY L GAULE3 | 415 S HARVEY AVE APT 2S OAK PARK, IL 60302 | AFLAC | $48 | — | $48 | 0.09% |
| CASEY J HIGGINS3 | 9347 LIZARD ROCK TRL COLORADO SPRINGS, CO 80924 | AFLAC | $31 | — | $31 | 0.06% |
| JV FLORIDA INSURANCE CORP3 | 2821 N OCEAN BLVD APT 305 FT LAUDERDALE, FL 33308 | AFLAC | $31 | — | $31 | 0.06% |
| PATRICIA M LEACH3 | 4405 HONEYWOOD LN JACKSON, WI 53037 | AFLAC | $14 | $2 | $16 | 0.03% |
| HENRI INSURANCE SERVICES INC3 Filed as: HENRI INSURANCE SERVICES INC. | 18525 TORRENCE AVE STE F1 LANSING, IL 60438 | AFLAC | $12 | — | $12 | 0.02% |
| CHARLES H HENRI3 | 18525 TORRENCE AVE STE F1 LANSING, IL 60438 | AFLAC | $9 | — | $9 | 0.02% |
| CHARLES H HENRI3 | 20105 DOLPHIN AVE LYNWOOD, IL 60411 | AFLAC | $5 | — | $5 | 0.01% |
| SHADEL & ASSOCIATES LLC Filed as: SHADEL & ASSOCIATES INC | 126 HOPKINS ST NEPTUNE BEACH, FL 32266 | AFLAC | $5 | — | $5 | 0.01% |
| JEREMY KOOI3 | 270 SHAKERAG ST MINERAL POINT, WI 53565 | AFLAC | $5 | — | $5 | 0.01% |
| CHRISTOPHER J ZELLNER3 | 918 ALDORA LN WAUNAKEE, WI 53597 | AFLAC | $5 | — | $5 | 0.01% |
| ADAM THOMAS GARDNER3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $5 | — | $5 | 0.01% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 6.53% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $775 | — | $775 | 1.96% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | STANDARD INSURANCE COMPANY | $419 | — | $419 | 1.06% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 541362142 | UNITED HEALTHCARE INSURANCE COMPANY | $2K | — | $2K | 6.07% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DR KIMBERLY, WI 541362142 | UNITED HEALTHCARE INSURANCE COMPANY | $801 | — | $801 | 3.12% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 8.04% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $490 | — | $490 | 2.00% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | STANDARD INSURANCE COMPANY | $265 | — | $265 | 1.08% |
| SECURA CONSULTANTS LLC3 | 6465 WAYZATA BLVD STE 920 MINNEAPOLIS, WI 554261728 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.35% |
| JEFFRY BARTOSIC3 | 711 EISENHOWER DR KIMBERLY, WI 541362142 | METROPOLITAN LIFE INSURANCE COMPANY | $939 | — | $939 | 6.39% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 6000 CLEARWATER DR MINNETONKA, MN 553439448 | METROPOLITAN LIFE INSURANCE COMPANY | $614 | — | $614 | 4.18% |
| SECURA BROKERAGE LLC3 | 6465 WAYZATA BLVD STE 920 MINNEAPOLIS, MN 554261728 | METROPOLITAN LIFE INSURANCE COMPANY | $273 | — | $273 | 1.86% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | STANDARD INSURANCE COMPANY | $251 | — | $251 | 1.74% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 6830 COCHRAN ROAD SOLON, OH 44139 | STANDARD INSURANCE COMPANY | $136 | — | $136 | 0.94% |
| UMR, INC.5 Filed as: UNITED HEALTHCARE BENEFIT SERVICES | 10701 WEST RESEARCH DRIVE WAUWATOSA, WI 53226 | UNITED HEALTHCARE BENEFIT SERVICES | — | $4K | $4K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Float revenue; Direct payment from the plan; Other fees; Claims processing Service code 12 | 3100 AMS BLVD GREEN BAY, WI 543139700 | $496K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | PO BOX 1067 WAUSAU, WI 544021087 | $57K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 1233 NORTH MAYFAIR ROAD MILWAUKEE, WI 53226 | $11K |
| USA INSURANCE SERVICES LLC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 711 EISENHOWER DR KIMBERLY, WI 541362142 | $5K |
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 | 263 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 216 | $26K |
| Life insurance | STANDARD INSURANCE COMPANY | 263 | $25K |
| Short-term disability | STANDARD INSURANCE COMPANY | 263 | $40K |
| Long-term disability | STANDARD INSURANCE COMPANY | 55 | $14K |
| Other(4 contracts, 4 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 200 | $566K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.