| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BURNS INSURANCE AGENCY LLC3 | 500 S CENTRAL AVENUE MARSHFIELD, WI 54449 | SECURITY HEALTH PLAN OF WISCONSIN, INC. | $13K | $0 | $13K | 2.15% |
| BURNS INSURANCE AGENCY LLC3 | 500 S CENTRAL AVE MARSHFIELD, WI 54449 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 8.28% |
| RENELLE THERESA ROESLER3 | 2812 MIRAMAR DR CARROLLTON, TX 75007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $331 | $3K | 7.40% |
| TRACY LEE BAILEY3 | 29717 131ST ST PRINCETON, MN 55371 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $567 | $937 | $2K | 3.24% |
| BRENDA LEE CANNING3 | 4227 THRU ST SAINT CLOUD, MN 56303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $960 | $438 | $1K | 3.01% |
| DEBRA FERRAO3 | 7102 HEATHERTON TRL MINNEAPOLIS, MN 55435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $262 | $449 | $711 | 1.53% |
| LAWRENCE RAY TERRY3 | 411 WINGSPAN DR ORMOND BEACH, FL 32174 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $400 | $0 | $400 | 0.86% |
| BLUE SKY BENEFIT SOLUTIONS INC3 | 4010 CLEARWATER RD APT 202 SAINT CLOUD, MN 56301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | $0 | $230 | 0.50% |
| ANGELA JEAN SUNDE RICH3 | 2351 40TH AVE SE ROCHESTER, MN 55904 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $164 | $0 | $164 | 0.35% |
| LINDSEY BARNES3 | 31196 151ST ST NW PRINCETON, MN 55371 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | $9 | $129 | 0.28% |
| INSURANCE SERVICE CENTER INC3 Filed as: INSURANCE SERVICE | PO BOX 787 MARSHFIELD, WI 54449 | COMPANION LIFE INSURANCE COMPANY | $2K | $0 | $2K | 11.49% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 5110 N 40TH STREET SUITE 234 PHOENIX, AZ 85018 | COMPANION LIFE INSURANCE COMPANY | $905 | $0 | $905 | 5.74% |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 66 | $587K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 117 | $16K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 107 | $46K |
| Prescription drug | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 66 | $587K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.