| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHELLY VANYO INVESTMENTS INC3 | 1929 CYPRESS CT NE UNIT 8 MENOMONIE, WI 54751 | AFLAC | $8K | $365 | $8K | 6.89% |
| MICHAEL BECK3 Filed as: MICHAEL J BECK | 645 8TH ST N HUDSON, WI 54016 | AFLAC | $3K | $85 | $3K | 2.75% |
| MICHAEL A PEDERSON3 | 101 N FARWELL ST STE 203MB203 EAU CLAIRE, WI 54703 | AFLAC | $1K | $79 | $1K | 1.09% |
| PATRICIA L OBERMUELLER3 | 1421 BROADWAY ST N STE 108 MENOMONIE, WI 54751 | AFLAC | $479 | $0 | $479 | 0.41% |
| MARK HOLZINGER3 Filed as: MARK RANCE PASSI | 3503 MCELROY ST EAU CLAIRE, WI 54701 | AFLAC | $322 | $0 | $322 | 0.28% |
| CHRISTOPHER P DOOLEY3 | 2903 NORTHWINDS DR EAU CLAIRE, WI 54701 | AFLAC | $284 | $0 | $284 | 0.24% |
| SAMANTHA J BREUER3 | E4355 PINEWOOD CIR ELEVA, WI 54738 | AFLAC | $195 | $0 | $195 | 0.17% |
| TAD HOWARD ASP3 | 10890 N SMITH RD HAYWARD, WI 54843 | AFLAC | $135 | $6 | $141 | 0.12% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $86 | $0 | $86 | 0.07% |
| GREGORY M HAUGEN3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $70 | $0 | $70 | 0.06% |
| ADAM THOMAS GARDNER3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $44 | $0 | $44 | 0.04% |
| WILLIAM F MURRAY III3 | 1298 SAINT PATRICK WAY SUN PRAIRIE, WI 53590 | AFLAC | $22 | $0 | $22 | 0.02% |
| JEREMY KOOI3 | 270 SHAKERAG ST MINERAL POINT, WI 53565 | AFLAC | $14 | $0 | $14 | 0.01% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $13 | $0 | $13 | 0.01% |
| JAMES W BENCIN3 | 11 SHELDRAKE LN WEST PALM BEACH, FL 33418 | AFLAC | $9 | $0 | $9 | 0.01% |
| CHRISTOPHER J ZELLNER3 | 918 ALDORA LN WAUNAKEE, WI 53597 | AFLAC | $8 | $0 | $8 | 0.01% |
| JOHN P DEERING3 | 518 HUDSON ST AUGUSTA, WI 54722 | AFLAC | $5 | $0 | $5 | 0.00% |
| KNUTE NELSON3 | 920 AUTUMN SAGE WAY PFLUGERVILLE, TX 78660 | AFLAC | $3 | $0 | $3 | 0.00% |
| KENNETH J HOFFMAN3 | N65W13544 COBBLESTONE CT MENOMONEE FALLS, WI 53051 | AFLAC | $1 | $0 | $1 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 6160 GOLDEN HILLS DR MINNEAPOLIS, MN 55416 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $8K | $0 | $8K | 15.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 6160 GOLDEN HILLS DR MINNEAPOLIS, MN 55416 | VISION SERVICE PLAN | $1K | $0 | $1K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 | UNKNOWN UNKNOWN, MN 00000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $303 | $0 | $303 | 10.00% |
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 | 216 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 216 | $1.9M |
| Vision | VISION SERVICE PLAN | 130 | $13K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 216 | $170K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 216 | $53K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 216 | $53K |
| Other(3 contracts, 3 carriers) | AFLAC | 216 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 216 | — |
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.