| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $21K | $820 | $22K | 2.17% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $4K | — | $4K | 2.47% |
| ROGERS BENEFIT GROUP INC3 | 2340 S RIVER RD STE 211 DES PLAINES, IL 600183223 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | — | $7K | 5.01% |
| DAVE JOHN VANDEHEY3 Filed as: DAVE J VANDEHEY | 311 E ANN ST STE 2 KAUKAUNA, WI 541303970 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 4.38% |
| VANDEHEY FINANCIAL SERVICES3 Filed as: VANDEHEY FINANCIAL SERVICES INC | 311 E ANN ST STE 2 KAUKAUNA, WI 541303970 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 2.47% |
| VAN DE HEY FINANCIAL SERVICE3 Filed as: VAN DE HEY FINANCIAL SERVICES | 311 E ANN ST STE 2 KAUKAUNA, WI 541303970 | THE PAUL REVERE LIFE INSURANCE COMPANY | $3K | — | $3K | 11.84% |
| VAN DE HEY FINANCIAL SERVICE3 | 311 EAST ANN ST. SUITE 2 KAUKAUNA, WI 54130 | CARE-PLUS DENTAL PLANS, INC. | $636 | — | $636 | 6.00% |
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 | 109 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 162 | $1.1M |
| Dental(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 243 | $142K |
| Vision(3 contracts, 3 carriers) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 243 | $1.3M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 243 | $131K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 243 | $131K |
| Long-term disability | THE PAUL REVERE LIFE INSURANCE COMPANY | 105 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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."
No prospect flags tripped on this filing.