| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 318 S WASHINGTON ST GREEN BAY, WI 54301 | HCC LIFE INSURANCE COMPANY | $54K | $18K | $72K | 10.71% |
| AUXIANT | 2450 RIMROCK ROAD MADISON, WI 53713 | HCC LIFE INSURANCE COMPANY | $1K | — | $1K | 0.21% |
| CAMERON SUTTON ROBERTS3 | N9404 ROSELLA DRIVE APPLETON, WI 54915 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $446 | $3K | 5.40% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 4.11% |
| RODNEY JAMES SONNENBERG3 | 432 AMORY ST FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $944 | $46 | $990 | 2.02% |
| DANIEL FROST3 | 241 POYGAN RD OMRO, WI 54963 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $878 | $74 | $952 | 1.94% |
| ADAM J ZAHN3 | 725 E GRANT STREET APPLETON, WI 54911 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $507 | $47 | $554 | 1.13% |
| MAYNARD IRVIN HEBERT II3 | 106 CUMBERLYNN DR FOND DU LAC, WI 54935 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | — | $157 | 0.32% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 6.99% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 1103 HUNTER DR MOUNT PLEASANT, WI 54306 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 13.23% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 13.52% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WI EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | 2801 HOOVER RD STEVENS POINT, WI 54481 | $8K |
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 | 173 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 173 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HCC LIFE INSURANCE COMPANY | 127 | $671K |
| Dental | HCC LIFE INSURANCE COMPANY | 127 | $671K |
| Vision | HCC LIFE INSURANCE COMPANY | 127 | $671K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 173 | $79K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 173 | $97K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 173 | $72K |
| Prescription drug | HCC LIFE INSURANCE COMPANY | 127 | $671K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 127 | $671K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 173 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 173 | — |
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.