| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J A COUNTER & ASSOCIATES INC3 Filed as: JA COUNTER & ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | 1.98% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC. | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $3K | $14K | 19.39% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.93% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 19.49% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 2.99% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.93% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.29% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 4.78% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 3.19% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC. | PO BOX 387 NEW RICHMOND, WA 54017 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ACTIVATE HEALTHCARE, LLC EIN 27-0908752 OTHER | Other services Service code 49 | 1400 WEWATTA ST., STE 350 DENVER, CO 80202 | $99K |
| BENEFITS PLAN ADMINISTRATOR EIN 41-1479417 CLAIMS PROCESSING | Claims processing Service code 12 | — | $77K |
| MEGELLAN RX MANAGEMENT, LLC EIN 46-3708039 PHARMACY BENEFIT MGT | Direct payment from the plan; Claims processing; Other fees Service code 12 | — | $7K |
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 | 249 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 266 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 159 | $85K |
| Vision | WYSSTA INSURANCE COMPANY INC | 104 | $15K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 249 | $84K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $43K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 150 | $72K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 180 | $759K |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 249 | $156K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.