| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SCHWARZ INSURANCE3 Filed as: SCHWARZ INSURANCE CO | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | UNITY HEALTH PLANS INSURANCE CORPORATION | $34K | $0 | $34K | 1.05% |
| SCHWARZ INSURANCE AGENCY INC3 Filed as: SCHWARZ INSURANCE AGENCY | 1420 N RIDGE DRIVE PRAIRIE DU SAC, WI 53578 | DEAN HEALTH PLAN INC | $19K | $0 | $19K | 1.61% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 N RIDGE DR PRAIRIE DU SAC, WI 53578 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $0 | $6K | 1.62% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $24K | — | $24K | 8.00% |
| GROUP INSURANCE SVCS INC3 | PO BOX 901 PRAIRIE DU SAC, WI 60566 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $12K | $0 | $12K | 4.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $6K | $6K | 1.83% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $22K | $0 | $22K | 10.00% |
| GROUP INSURANCE SVCS INC3 | PO BOX 901 NAPERVILLE, IL 60566 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 5.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 2.05% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $11K | $0 | $11K | 10.00% |
| GROUP INSURANCE SVCS INC3 | PO BOX 901 NAPERVILLE, IL 60566 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 5.00% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.92% |
| SCHWARZ INSURANCE3 Filed as: SCHWARZ INSURANCE CO | 1420 N RIDGE DRIVE PRAIRIE DU SAC, WI 53578 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 22.80% |
| SCHWARZ INSURANCE AGENCY INC3 | 1420 NORTH RIDGE DR PRAIRIE DU SAC, WI 53578 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $621 | $0 | $621 | 10.00% |
| GROUP INSURANCE SVCS INC3 | PO BOX 901 NAPERVILLE, IL 60566 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $311 | $0 | $311 | 5.01% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $129 | $129 | 2.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | — | $45K |
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 | 988 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 999 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 1,034 | $472K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,034 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.