| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN GROUP- HG | 700 REGENT STREET #400 MADISON, WI 53715 | DEAN HEALTH PLAN INC | $20K | — | $20K | 2.25% |
| MICHAEL HARP3 | 2900 WEST RD EAST LANSING, MI 48823 | PHYSICIANS HEALTH PLAN | $7K | — | $7K | 4.00% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $434 | $2K | 6.77% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $271 | $271 | 1.11% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 9.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $874 | $335 | $1K | 6.92% |
| BENEFIT ADVISOR NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $209 | $209 | 1.20% |
| MICHAEL HARP3 | 2900 WEST RD EAST LANSING, MI 48823 | DELTA DENTAL OF MICHIGAN | $1K | — | $1K | 9.27% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 14.99% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $434 | $321 | $755 | 8.69% |
| BENEFIT ADVISOR NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $201 | $201 | 2.31% |
| STRATEGIC BENEFITS NETWORK LLC3 Filed as: STRATEGIC BENEFITS NETWORK | 2900 WEST RD STE 222 EAST LANSING, MI 48823 | PRINCIPAL LIFE INSURANCE COMPANY | $516 | — | $516 | 20.54% |
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 | 145 | 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) | 148 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | DEAN HEALTH PLAN INC | 156 | $1.1M |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 229 | $96K |
| Vision(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 229 | $86K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 100 | $17K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 100 | $24K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 100 | $9K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 100 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.