| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS GREAT PLAINS LLC | DBA AVID RISK SOLUTIONS MIDDLETON, WI 53562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12K | $99 | $13K | 9.71% |
| KATIE AUSTIN SELZ3 | 4373 BENT GRASS CT WINDSOR, WI 53598 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $3K | $8K | 6.45% |
| DANIEL SELZ3 | 4373 BENT GRASS CT WINDSOR, WI 53598 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $4K | $6K | 4.90% |
| ERICK TAVAREZ3 | 212 SPRINGVIEW DRIVE MARSHALL, WI 53559 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $5K | 4.17% |
| GERALD A GREENEN3 | 472 ROUTE 47 STE F-102 SUGAR GROVE, IL 60554 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $2K | $5K | 4.14% |
| VALUE ADDED SOLUTIONS3 | 1161 HERITAGE CT. SUN PRAIRIE, WI 53590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $3K | $5K | 3.84% |
| AVID RISK SOLUTIONS INC.3 | 2501 PARMENTER ST STE 200A MIDDLETON, WI 53562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 3.27% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS GREAT PLAINS LLC | DBA AVID RISK SOLUTIONS MIDDLETON, WI 53562 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $269 | $4K | 2.87% |
| MARY R ROEMER3 | N16W26577 WILD OATS DRIVE UNIT E PEWAUKEE, WI 53072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $779 | $3K | 2.19% |
| MATTHEW C HARSH3 | 1523 HAVERHILL DRIVE WHEATON, IL 60189 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $963 | $433 | $1K | 1.08% |
| JODY ANN WALL3 | 1334 ROCKRIDGE RD APT 331 WAUKESHA, WI 53188 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $31 | $1K | 0.92% |
| CORCORAN & HOYT LLC3 | 3905 TAMPA ROAD OLDSMAR, FL 34677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $593 | $254 | $847 | 0.65% |
| JAMES CALLAHAN3 | 312 MONTEREY DRIVE BOLINGBROOK, IL 60440 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $487 | $0 | $487 | 0.38% |
| WENDY L SENN3 | 1225 DAISY DRIVE WEST BEND, WI 53090 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $376 | $0 | $376 | 0.29% |
| RICHARD BALLWEG3 | 5518 PARK WAY MADISON, WI 53705 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $367 | — | $367 | 0.28% |
| MARK HOLZINGER3 | 118 E HAMILTON AVE EAU CLAIRE, WI 54701 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $152 | — | $152 | 0.12% |
| JANET BURACZEWSKI3 Filed as: JANET S BURACZEWSKI | N8279 22ND AVENUE NESHKORO, WI 54960 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $131 | — | $131 | 0.10% |
| JOESPH PATRICK HOFFMAN3 | 601 N THORNBUSH CIRCLE HARTLAND, WI 53029 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $21 | $24 | 0.02% |
| OWENS EMPLOYEE BENEFITS OF FLORIDA3 | 13650 FIDDLESTICKS BLVD FORT MYERS, FL 33912 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
| BARBARA ANN SAXTON3 | 18990 S TAMIAMI TRAIL STE 4 FORT MYERS, FL 33908 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.01% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 226 | $129K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 226 | $129K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 226 | $129K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.