| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | PO BOX 45470 MADISON, WI 53717 | SECURITY HEALTH PLAN OF WISCONSIN, INC. | $19K | — | $19K | 1.36% |
| ANSAY & ASSOCIATES LLC3 | 888 STATE HWY 153 SUITE 200 MOSINEE, WI 54455 | HARTFORD LIFE AND ACCIDENT | $12K | — | $12K | 11.66% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTLINE HIGHWAY SUITE 202 MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | — | $554 | $554 | 0.53% |
| WISCONSIN MEDICAL SOCIETY INS3 Filed as: WISCONSIN MEDICAL SOCIETY | 2450 RIMROCK RD STE 100 MADISON, WI 537130000 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 10.42% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | PO BOX 45470 MADISON, WI 53717 | SECURITY HEALTH PLAN OF WISCONSIN, INC. | $240 | — | $240 | 1.40% |
| ANSAY & ASSOCIATES LLC3 | 888 STATE HWY 153 SUITE 200 MOSINEE, WI 54455 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 19.99% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTLINE HIGHWAY SUITE 202 MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $0 | $45 | $45 | 0.40% |
| ANSAY & ASSOCIATES LLC3 | 888 STATE HWY 153 SUITE 200 MOSINEE, WI 54455 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $851 | — | $851 | 10.00% |
| ANSAY & ASSOCIATES LLC3 | 888 STATE HWY 153 SUITE 200 MOSINEE, WI 54455 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 20.00% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTLINE HIGHWAY SUITE 202 MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | — | $46 | $46 | 0.54% |
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 | 101 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 101 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 209 | $1.4M |
| Dental | DELTA DENTAL OF WISCONSIN | 71 | $54K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 158 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 101 | $105K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 101 | $105K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 101 | $105K |
| Prescription drug(2 contracts) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 209 | $1.4M |
| Other(3 contracts) | HARTFORD LIFE AND ACCIDENT | 101 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.