| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANTHONY N GOEBEL3 | 5111A GREEN VALLEY RD OSHKOSH, WI 54904 | WPS HEALTH PLAN INC | $34K | — | $34K | 4.85% |
| ANTHONY N GOEBEL3 | 5111A GREEN VALLEY RD OSHKOSH, WI 54904 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $10K | — | $10K | 3.86% |
| 5GBENEFITS LLC3 | 131 N ROLLING MEADOWS DRIVE FOND DU LAC, WI 549370000 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 6.35% |
| 5GBENEFITS LLC3 | 131 N ROLLING MEADOWS DRIVE FOND DU LAC, WI 54937 | HARTFORD LIFE AND ACCIDENT | $8K | — | $8K | 16.95% |
| JENNON M CARUTH3 | 1331 HEATHER CT CHANHASSEN, MN 55317 | HARTFORD LIFE AND ACCIDENT | $1K | — | $1K | 2.48% |
| 5GBENEFITS LLC3 | 131 N ROLLING MEADOWS DRIVE FOND DU LAC, WI 549370000 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 14.09% |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 85 | $71K |
| Vision | WYSSTA INSURANCE COMPANY INC | 61 | $8K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 114 | $50K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 114 | $50K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 114 | $50K |
| Other | HARTFORD LIFE AND ACCIDENT | 114 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.