| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRIS ZELLNER3 | 4001 FELLAND RD, STE 106 MADISON, WI 53718 | AFLAC | $3K | $72 | $3K | — |
| AMY KNUTSON3 | 421 HIGGINS DRIVE EVANSVILLE, WI 53536 | AFLAC | $1K | $27 | $1K | — |
| TED ALDWORTH3 | 3825 MONONA DRIVE APT 25 MADISON, WI 53714 | AFLAC | $850 | $27 | $877 | — |
| ROSS C NELSON3 | 4001 FELLAND RD STE 106 MADISON, WI 53718 | AFLAC | $532 | $52 | $584 | — |
| CASEY J HIGGINS3 | 2484 LEOPOLD WAY SUN PRAIRIE, WI 53590 | AFLAC | $528 | $35 | $563 | — |
| JASON SCZEPANIAK3 | 4001 FELLAND ROAD STE 106 MADISON, WI 53718 | AFLAC | $317 | $62 | $379 | — |
| KEVIN ZELLNER3 | 125 E HOLUM ST, APT 208 DEFOREST, WI 53532 | AFLAC | $273 | — | $273 | — |
| JEFFREY D HOEFNER3 Filed as: JEFFREY HOEFNER | 4001 FELLAND RD STE 113 MADISON, WI 53718 | AFLAC | $246 | $11 | $257 | — |
| MARILYN SHAW SCHUH3 | 3424 MIDVALE DR APT 2 JANESVILLE, WI 53546 | AFLAC | $135 | $69 | $204 | — |
| ANASTASIA JONES3 | 1025 N DANIELS CT APT B2 WHITEWATER, WI 53190 | AFLAC | $126 | — | $126 | — |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DR MADISON, WI 53546 | AFLAC | $124 | — | $124 | — |
| JOHN D KEYS3 Filed as: JOHN KREFT | 5605 OSBORN DR MCFARLAND, WI 53558 | AFLAC | $116 | — | $116 | — |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DR MADISON, WI 53713 | AFLAC | $89 | — | $89 | — |
| AMY KNUTSON3 | 421 HIGGINS DR EVANSVILLE, WI 53536 | AFLAC | $83 | — | $83 | — |
| CHRIS ZELLNER3 | 4001 FELLAND RD STE 106 MADISON, WI 53718 | AFLAC | $75 | — | $75 | — |
| KEVIN ZELLNER3 | 125 E HOLUM ST APT 208 DEFOREST, WI 53532 | AFLAC | $55 | $7 | $62 | — |
| MATTHEW A HOFELDT3 | 4918 LANTERN HOLLOW LN WAUNAKEE, WI 53597 | AFLAC | $47 | — | $47 | — |
| REBECCA A BAERTSCHI3 | 209 W MAIN ST BROOKLYN, WI 53521 | AFLAC | $47 | — | $47 | — |
| JOSHUA J PARISE3 | 7325 JANES AVE WOODRIDGE, IL 60517 | AFLAC | $43 | — | $43 | — |
| ELIZABETH A LENZO3 | 1949 S EUCLID AVE SAN MARINO, CA 91108 | AFLAC | $37 | — | $37 | — |
| MARILYN SHAW SCHUH3 | 624 CRANSTON RD BELOIT, WI 53511 | AFLAC | $30 | — | $30 | — |
| RYAN HEALY3 | 335 BLACKBERRY LN APT 202 DEFOREST, WA 53532 | AFLAC | $18 | — | $18 | — |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $16 | — | $16 | — |
| MAYNARD IRVIN HEBERT II3 Filed as: MAYNARD HERBERT II | 439 ELLIS ST FOND DU LAC, WI 54935 | AFLAC | $14 | — | $14 | — |
| RYAN HEALY3 | 335 BLACKBERRY LN APT 202 DEFOREST, WI 53532 | AFLAC | $11 | — | $11 | — |
| CHRIS ZELLNER3 Filed as: CHRIS SOULIER | 602 WILLIAM WAY WAUNAKEE, WI 53597 | AFLAC | $11 | — | $11 | — |
| NATHANIEL REWEY3 | 186 WAVERLY ST ARLINGTON, MA 02476 | AFLAC | $9 | — | $9 | — |
| MICHAEL FRASIER3 | 374 BELLA WAY SUN PRAIRIE, WI 53590 | AFLAC | $8 | — | $8 | — |
| MICHAEL FRASIER3 | 2996 WAUBESA AVE MADISON, WI 53711 | AFLAC | $7 | — | $7 | — |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP, LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | AFLAC | $5 | — | $5 | — |
| RACHEL KOS3 | 680 BOYLSTON ST NEWTON CENTER, MA 02459 | AFLAC | $4 | — | $4 | — |
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 | 114 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | AFLAC | 114 | $0 |
| Other | AFLAC | 114 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.