| 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 | 1.57% |
| 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 | $9K | $2K | $11K | 18.10% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.65% |
| 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 | $9K | $3K | $12K | 20.67% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.84% |
| 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 | — | $2K | $2K | 5.09% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 2.55% |
| 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 | — | $2K | $2K | 5.34% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $989 | $989 | 2.67% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC. | PO BOX 387 NEW RICHMOND, WI 54017 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BENEFITS PLAN ADMINISTRATOR EIN 41-1479417 CLAIMS PROCESSING | Claims processing Service code 12 | — | $96K |
| EVERSIDE HEALTH, LLC EIN 45-3449075 OTHER | Other services Service code 49 | 1400 WEWATTA ST., STE 350 DENVER, CO 80202 | $73K |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 177 | $103K |
| Vision | WYSSTA INSURANCE COMPANY INC | 114 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $94K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $48K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $58K |
| Stop-loss / reinsurancereinsurance | BERKSHIRE HATHAWAY SPECIALTY INSURANCE COMPANY | 197 | $1000K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 262 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.