| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 EAST GRAND AVE, SUITE 11 PORT WASHINGTON, WI 53074 | SECURITY HEALTH PLAN OF WISCONSIN, INC. | $30K | — | $30K | 1.49% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 EAST GRAND AVE SUITE 11 PORT WASHINGTON, WI 53074 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 10.00% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $45 | $45 | 0.04% |
| WISCONSIN MEDICAL SOCIETY INS3 Filed as: WISCONSIN MEDICAL SOCIETY | PO BOX 1109 MADISON, WI 537010000 | DELTA DENTAL OF WISCONSIN | $8K | — | $8K | 10.03% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTLINE HWY SUITE 202 MADISON, WI 53713 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 18.17% |
| ANSAY & ASSOCIATES LLC3 | 101 EAST GRAND AVE SUITE 11 PORT WASHINGTON, WI 53074 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 10.00% |
| MGIS3 | 111 SOUTH MAIN ST SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $45 | $45 | 0.14% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 EAST GRAND AVE, SUITE 11 PORT WASHINGTON, WI 53074 | SECURITY HEALTH PLAN OF WISCONSIN, INC. | $336 | — | $336 | 1.45% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 101 EAST GRAND AVENUE SUITE 11 PORT WASHINGTON, WI 53074 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 20.00% |
| MGIS3 | 111 SOUTH MAIN STREET SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $45 | $45 | 0.21% |
| ANSAY & ASSOCIATES LLC3 | 888 STATE HWY 153 SUITE 200 MOSINEE, WI 54455 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $1K | — | $1K | 10.00% |
| ANSAY & ASSOCIATES LLC3 | 101 EAST GRAND AVENUE SUITE 11 PORT WASHINGTON, WI 53074 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 10.00% |
| MGIS3 | 111 SOUTH MAIN ST SUITE 400 SALT LAKE CITY, UT 841112176 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $45 | $45 | 0.44% |
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 | 143 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 259 | $2.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 95 | $84K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 196 | $12K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 143 | $10K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 88 | $101K |
| Prescription drug(2 contracts) | SECURITY HEALTH PLAN OF WISCONSIN, INC. | 259 | $2.0M |
| Other(4 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 188 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 259 | — |
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.