| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JENI VIESTENZ3 | 108 PACKERLAND DR SUITE D GREEN BAY, WI 54303 | WPS HEALTH PLAN, INC. | $34K | — | $34K | 1.51% |
| JASON NORDBY3 | 828 JOHN NOLEN DR MADISON, WI 53713 | WPS HEALTH PLAN, INC. | $11K | — | $11K | 0.49% |
| FINANCIAL LIFE CYCLES INC3 | 108 PACKERLAND DR SUITE D GREEN BAY, WI 54303 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 2.06% |
| M3 INSURANCE SOLUTIONS INC3 | 1610 WYNKOOP STREET SUITE 300 DENVER, CO 80202 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 1.12% |
| FINANCIAL LIFE CYCLES INC3 | 108 PACKERLAND DR SUITE D GREEN BAY, WI 54303 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 9.31% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $852 | $207 | $1K | 2.56% |
| FINANCIAL LIFE CYCLES INC3 | 108 PACKERLAND DR SUITE D GREEN BAY, WI 54303 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 11.29% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $182 | $2K | 4.21% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WPS HEALTH PLAN, INC. | 319 | $2.2M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 172 | $139K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 392 | $78K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 392 | $41K |
| Prescription drug | WPS HEALTH PLAN, INC. | 319 | $2.2M |
| Other(2 contracts, 2 carriers) | WPS HEALTH PLAN, INC. | 392 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 392 | — |
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.