| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN-JOHNSON INSURANCE INC3 | 700 REGENT ST. #400 MADISON, WI 53725 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $37K | — | $37K | 4.80% |
| HAUSMAN JOHNSON INSURANCE INC3 | PO BOX 259408 MADISON, WI 53735 | AMERITAS LIFE INSURANCE CORP. | $3K | $463 | $3K | 4.14% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME, INC. | 700 REGENT ST. MADISON, WI 53715 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $750 | $3K | 21.19% |
| THIRD COAST ADVISORS INC3 | 1166 QUAIL CT #100 PEWAUKEE, WI 53072 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22 | — | $22 | 0.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FAMILY SERVICE MADISON, INC. GENERAL CONSULTING | Consulting (general); Employee (plan) Service code 16 | 128 EAST OLIN AVE MADISON, WI 53713 | $11K |
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 | 518 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 34 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 564 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 124 | $772K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 248 | $83K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 248 | $83K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 53 | $14K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 53 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.