| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 53725 | DEAN HEALTH PLAN INC | $18K | — | $18K | 2.14% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53715 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 5.19% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $340 | $5K | 16.12% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $113 | $2K | 5.37% |
| BENEFIT ADVISOR NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $142 | $142 | 0.47% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $719 | $4K | 12.58% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | $240 | $2K | 5.86% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $300 | $300 | 1.08% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $514 | $2K | 11.63% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $978 | $171 | $1K | 5.88% |
| BENEFIT ADVISOR NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $214 | $214 | 1.09% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53715 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.02% |
| INGENIUM PRIME INC3 | PO BOX 259408 MADISON, WI 53725 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $169 | $38 | $207 | 12.27% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $84 | $13 | $97 | 5.75% |
| BENEFIT ADVISOR NETWORK LLC3 | 6830 COCHRAN ROAD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $16 | $16 | 0.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MCLAREN EIN 27-2204037 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $339K |
| MICHIGAN GROUP BENEFITS INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | 2900 WEST RD STE 222 EAST LANSING, MI 48823 | $17K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $3K |
| HAUSMANN GROUP, INC. INS AGENTS AND BROKERS | Insurance agents and brokers Service code 22 | 740 REGENT ST 4TH FLOOR MADISON, WI 53725 | $206 |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 171 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DEAN HEALTH PLAN INC | 150 | $829K |
| Dental | DELTA DENTAL OF WISCONSIN | 116 | $99K |
| Vision | WYSSTA INSURANCE COMPANY INC | 89 | $14K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 126 | $20K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 126 | $28K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 121 | $30K |
| Other(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 126 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 150 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.