| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HEMB INSURANCE GROUP LLC3 | 2801 COHO ST #200 MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $23K | $0 | $23K | 1.17% |
| HEMB INSURANCE GROUP LLC3 | 2801 COHO ST STE 200 MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $8K | $0 | $8K | 9.70% |
| ANDREW P SHULLA3 Filed as: ANDREW PETER SHULLA | 1600 ASPEN CMNS STE 900 MIDDLETON, WI 53562 | NORTHWESTERN MUTUAL LIFE | $4K | $1K | $5K | 12.42% |
| WIIL HOLDINGS LLC3 | 1600 ASPEN CMNS STE 900 MIDDLETON, WI 53562 | NORTHWESTERN MUTUAL LIFE | $819 | $98 | $917 | 2.22% |
| ANDREW P SHULLA3 Filed as: ANDREW PETER SHULLA | 1600 ASPEN CMNS STE 900 MIDDLETON, WI 53562 | NORTHWESTERN MUTUAL LIFE | $2K | $586 | $3K | 8.92% |
| WIIL HOLDINGS LLC3 | 1600 ASPEN CMNS STE 900 MIDDLETON, WI 53562 | NORTHWESTERN MUTUAL LIFE | $465 | $56 | $521 | 1.60% |
| HEMB INSURANCE GROUP LLC3 | 2801 COHO ST STE 200 MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 15.10% |
| HEMB INSURANCE GROUP LLC3 | 2801 COHO ST STE 200 MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $691 | $0 | $691 | 8.05% |
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 | 105 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 105 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 77 | $80K |
| Vision | WYSSTA INSURANCE COMPANY INC | 57 | $9K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 105 | $25K |
| Short-term disability | NORTHWESTERN MUTUAL LIFE | 105 | $33K |
| Long-term disability | NORTHWESTERN MUTUAL LIFE | 105 | $41K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 285 | $2.0M |
| Other | HARTFORD LIFE AND ACCIDENT | 105 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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.