| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LINDA SKOGLUND3 | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | PREVEA360 HEALTH PLAN | $58K | — | $58K | 3.00% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | PO BOX 387 NEW RICHMOND, WI 54017 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 9.56% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.77% |
| NATIONAL BENEFITS CENTER LLC3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.37% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $1K | $5K | 12.77% |
| NATIONAL BENEFITS CENTER LLC3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $889 | $889 | 2.37% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | PO BOX 387 NEW RICHMOND, WI 54017 | CONTINENTAL AMERICAN INSURANCE COMPANY | $10K | — | $10K | 25.74% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $2K | $10K | 26.23% |
| NATIONAL BENEFITS CENTER LLC3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.63% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $768 | $3K | 13.27% |
| NATIONAL BENEFITS CENTER LLC3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $658 | $658 | 2.80% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J.A. COUNTER & ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | VISION SERVICE PLAN | $1K | — | $1K | 5.37% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $5K |
| JA COUNTER & ASSOCIATES, INC. INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | 1477 S KNOWLES AVE, STE 200 NEW RICHMOND, WI 54017 | $253 |
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 | 162 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREVEA360 HEALTH PLAN | 303 | $1.9M |
| Dental | DELTA DENTAL OF WISCONSIN | 168 | $106K |
| Vision | VISION SERVICE PLAN | 169 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $60K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $69K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 261 | $37K |
| Other(3 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 261 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.