| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HANEY, GINA M3 | HAUSMANN GROUP INC 740 REGENT STREET #400 MADISON, WI 53715 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $19K | — | $19K | 2.92% |
| OBERLOH, JESSE D3 | HAUSMANN GROUP INC 740 REGENT ST SUITE 400 MADISON, WI 53715 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $17K | — | $17K | 2.64% |
| HAUSMAN JOHNSON INSURANCE INC3 | PO BOX 259408 MADISON, WI 53735 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 4.49% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME, INC. | 740 REGENT ST. MADISON, WI 53715 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.58% |
| THIRD COAST ADVISORS INC3 | 1166 QUAIL CT #100 PEWAUKEE, WI 53072 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $28 | — | $28 | 0.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FAMILY SERVICE MADISON, INC. GENERAL CONSULTING | Employee (plan); Consulting (general) Service code 16 | 128 EAST OLIN AVE MADISON, WI 53713 | $12K |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 8 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 123 | $657K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 224 | $60K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 224 | $60K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 65 | $18K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 65 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.