| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIETZ, MICHAEL T.3 | 5733 W PACKARD ST APPLETON, WI 54913 | WPS HEALTH PLAN INC | $14K | — | $14K | 1.53% |
| THOMAS PRECIA3 | 2120 PEWAUKEE ROAD, STE 202 WAUKESHA, WI 53188 | WPS HEALTH PLAN INC | $3K | — | $3K | 0.31% |
| MELISSA ANN WERNER3 Filed as: MELISSA WERNER | 2500 E ENTERPRISE DR STE D APPLETON, WI 54913 | WPS HEALTH PLAN INC | $1K | — | $1K | 0.17% |
| JT SPAETH INC DBA SPAETH BARRET3 Filed as: JT SPAETH,INC. | 330 E KILBOURN AVE STE 950 MILWAUKEE, WI 53202 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 7.89% |
| MIDWEST INSURANCE BROKERAGE LTD3 Filed as: MIDWEST INSURANCE BROKERAGE, LTD | 5733 W PACKARD ST. APPLETON, WI 54913 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 11.30% |
| JT SPAETH INC DBA SPAETH BARRET3 | 330 E KILBOURN AVE STE 950 MILWAUKEE, WA 53202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 2.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 2120 PEWAUKEE RD STE 202 WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $47 | $2 | $49 | 0.08% |
| MIDWEST INSURANCE BROKERAGE LTD3 Filed as: MIDWEST INSURANCE BROKERAGE, LTD | 5733 W PACKARD ST. APPLETON, WI 54913 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 11.28% |
| JT SPAETH INC DBA SPAETH BARRET3 | 330 E KILBOURN AVE MILWAUKEE, WI 53202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $467 | — | $467 | 2.52% |
| HUB INTERNATIONAL MIDWEST LIMITED3 | 2120 PEWAUKEE RD STE 202 WAUKESHA, WI 53188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $16 | $1 | $17 | 0.09% |
| MIDWEST INSURANCE BROKERAGE LTD3 Filed as: MIDWEST INSURANCE BROKERAGE, LTD | 5733 W PACKARD ST. APPLETON, WI 54913 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $220 | — | $220 | 3.79% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 2120 PEWAUKEE ROAD SUITE 202 WAUKESHA, WA 53188 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $49 | — | $49 | 0.84% |
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 | 107 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WPS HEALTH PLAN INC | 149 | $891K |
| Dental | DELTA DENTAL OF WISCONSIN | 55 | $60K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 35 | $6K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $77K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $58K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $77K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.