| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $2K | $2K | $4K | 4.32% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $1K | $2K | $3K | 4.30% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | VISION SERVICE PLAN | $1K | — | $1K | 3.44% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | VISION SERVICE PLAN | $227 | — | $227 | 0.53% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $379 | $509 | $888 | 4.32% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $308 | $401 | $709 | 4.30% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $265 | $346 | $611 | 4.30% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $200 | $268 | $468 | 4.32% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $178 | — | $178 | 1.91% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $168 | $226 | $394 | 4.32% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $146 | — | $146 | 1.90% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $82 | $110 | $192 | 4.32% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $80 | — | $80 | 1.91% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $70 | — | $70 | 1.90% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $67 | $88 | $155 | 4.31% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $44 | $67 | $111 | 4.03% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $17 | — | $17 | 1.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN (DENT) | Contract Administrator Service code 13 | — | $13K |
| USI INSURACE SERVICES LLC-WI INS AGENT OR BROKER | Insurance agents and brokers Service code 22 | 711 EISENHOWER DR KIMBERLY, WA 54136 | $827 |
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 | 368 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 290 | $43K |
| Life insurance(5 contracts) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 411 | $108K |
| Short-term disability(5 contracts) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 268 | $26K |
| Long-term disability(5 contracts) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 267 | $127K |
| Other | ERC, INC. | 604 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 604 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.