| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 555 MAIN ST. STE 291 RACINE, WI 534031000 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $1K | — | $1K | 10.00% |
| MELISSA WIDUCKI3 | 311 FINANCIAL WAY STE 220 WAUSAU, WI 54401 | AFLAC | $9K | $230 | $9K | — |
| BEJAMIN BAKER3 | 5351 BROADWAY ST NEWALD, WI 54511 | AFLAC | $5K | $257 | $5K | — |
| ALICE MAGUIRE3 | 4512 TWIN PINES LN WESTON, WI 54476 | AFLAC | $2K | $75 | $2K | — |
| RICKY E ROBINSON3 Filed as: RICKY ROBINSON | 934 SWEENEY DR STE ONE HAGERSTOWN, MD 21740 | AFLAC | $1K | $13 | $1K | — |
| BRIAN S LOWE3 | 920 SARDIS DR BOAZ, AL 35956 | AFLAC | $841 | — | $841 | — |
| LISA M LOUDIN3 Filed as: LISA LOUDIN | 2129 GUILFORD RD ROCKFORD, IL 61107 | AFLAC | $552 | $60 | $612 | — |
| SALLY ANN WHITE3 | 3051 PROGRESS WAY STE 204 KAUKAUNA, WI 54130 | AFLAC | $495 | — | $495 | — |
| JOHNSON INSURANCE SERVICES LLC3 | 318 S WASHINGTON ST STE 200 GREEN BAY, WI 53401 | AFLAC | $411 | — | $411 | — |
| DAVID R PONTA3 Filed as: DAVID PONTA | 145 S DUKE ST STE B YORK, PA 17401 | AFLAC | $243 | — | $243 | — |
| ALISON M MORROW3 Filed as: ALISON MORROW | 311 FINANCIAL WAY STE 220 WAUSAU, WI 54401 | AFLAC | $230 | — | $230 | — |
| SHANNON A LADING3 | 738 W 4TH ST APPLETON, WI 54914 | AFLAC | $207 | — | $207 | — |
| PETER J TEKAMPE3 | 815 N CHURCH ST ROCKFORD, IL 61103 | AFLAC | $130 | $12 | $142 | — |
| DAVID W BRANDT3 Filed as: DAVID BRANDT | 46 WINDSOR WAY RED LION, PA 17356 | AFLAC | $142 | — | $142 | — |
| LYNN KARL3 | W10030 PARKSIDE LN ANTIGO, WI 54409 | AFLAC | $136 | $5 | $141 | — |
| PAUL W DESPIRITO3 | 3051 PROGESS WAY STE 204 KAUKAUNA, WI 54130 | AFLAC | $139 | — | $139 | — |
| DEWAYNE D RAY3 | PO BOX 41 GUNTERSVILLE, AL 35976 | AFLAC | $136 | — | $136 | — |
| BRYAN FISH3 | 4050 CANDLE LIGHT DR DAYTON, MD 21036 | AFLAC | $125 | $2 | $127 | — |
| FINANCIAL LIFE CYCLES INC3 | 318 S WASHINGTON ST GREEN BAY, WI 54301 | AFLAC | $126 | — | $126 | — |
| MICHAEL J SKOFF3 Filed as: MICHAEL SKOFF | 815 N CHURCH ST ROCKFORD, IL 61103 | AFLAC | $106 | $12 | $118 | — |
| BETH LUANNE KIMBROUGH3 Filed as: BETH KIMBROUGH | 6750 N ANDREWS AVE STE 200 FT LAUDERDALE, FL 33309 | AFLAC | $94 | — | $94 | — |
| KELVIN MICHAEL RICE3 | 529 EDINBURGH WAY DOTHAN, AL 36305 | AFLAC | $81 | — | $81 | — |
| BRANDT INC3 | 360 LOUCKS RD STE 305 YORK, PA 17404 | AFLAC | $71 | — | $71 | — |
| TRICIA BLAIR3 | 311 FINANCIAL WAY STE 220 WAUSAU, WI 54401 | AFLAC | $56 | — | $56 | — |
| ROBERT J DONOHUE3 Filed as: ROBERT DONOHUE | 808 FAIRWAY DRIVE MOSINEE, WI 54455 | AFLAC | $48 | — | $48 | — |
| JAMEY MILLER INC3 | 2202 57TH ST SE AUBURN, WA 98092 | AFLAC | $35 | — | $35 | — |
| JOHN BROOKS3 | 4031 LEETH GAP RD BOAZ, AL 35956 | AFLAC | $33 | — | $33 | — |
| KRISTIN L ARVIGO3 | 917 WOODLANE AVE ROCKFORD, IL 61107 | AFLAC | $27 | — | $27 | — |
| MARK JOHNSTON3 | 124 UNDERKE TER HEDGESVILLE, WV 25427 | AFLAC | $26 | — | $26 | — |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $26 | — | $26 | — |
| RAMON PURVIS3 | 380 VALLEY DR FAYETTEVILLE, PA 17222 | AFLAC | $25 | — | $25 | — |
| GLEN T SCHWEIKERT3 Filed as: GLEN SCHWEIKERT | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $24 | — | $24 | — |
| PATRICK KREFT3 | 107 EDDY RD EDGAR, WI 54426 | AFLAC | $24 | — | $24 | — |
| STEVEN T SPEICHINGER3 Filed as: STEVEN SPEICHINGER | 3008 CHRISTIAN AVE WAUSAU, WI 54401 | AFLAC | $18 | — | $18 | — |
| TRICIA SCHOENECK3 | 3462 COLUMBUS LAKE RD EAGLE RIVER, WI 54521 | AFLAC | $17 | — | $17 | — |
| KIMBERLY L LUSHBAUGH3 Filed as: KIMBERLY LUSHBAUGH | 14 CATAWBA CIRCLE HAGERSTOWN, MD 21742 | AFLAC | $16 | — | $16 | — |
| MARK D BARBIER3 Filed as: MARK BARBIER | 23 CROYDON LN OAK BROOK, IL 60523 | AFLAC | $12 | — | $12 | — |
| SAMANTHA J BREUER3 | E4355 PINEWOOD CIR ELEVA, WI 54738 | AFLAC | $9 | — | $9 | — |
| DENNIS J CASSENS3 Filed as: DENNIS CASSENS | 4646 E MARRILL RD STE 1 BYRON, IL 61010 | AFLAC | $9 | — | $9 | — |
| JEREMY KOOI3 | 270 SHAKERAGE ST MINERAL POINT, WI 53565 | AFLAC | $9 | — | $9 | — |
| JEFFREY A. MUSSOLINO3 Filed as: JEFFREY A MUSSOLINO | 805 HAMILTON BLVD HAGERSTOWN, MD 21742 | AFLAC | $9 | — | $9 | — |
| IRENE E BROOKS3 Filed as: IRENE BROOKS | 101 COPPER BEECH LN WOMELSDORF, PA 19567 | AFLAC | $8 | — | $8 | — |
| BARBARA ANN MCNAUGHTON3 | 4910 CORPORATE DR NW STE G HUNTSVILLE, AL 35805 | AFLAC | $7 | — | $7 | — |
| ARON D TERAN3 Filed as: ARON TERAN | 3812 CARRIAGE HILL DR FREDERICK, MD 21704 | AFLAC | $7 | — | $7 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL WALKER | 203 MARKET ST STE 201 HARVRE DE GRACE, MD 21078 | AFLAC | $6 | — | $6 | — |
| WILLIAM F MURRAY III3 Filed as: WILLIAM MURRAY III | 1298 SAINT PATRICK WAY SUN PRAIRIE, WI 53590 | AFLAC | $5 | — | $5 | — |
| ROSS C NELSON3 Filed as: ROSS NELSON | 440 REGENCY PARKWAY DR STE 234 OMAHA, NE 68114 | AFLAC | $5 | — | $5 | — |
| TAYLEN C ARVIGO3 | 309 S 4TH ST OREGON, IL 61061 | AFLAC | $5 | — | $5 | — |
| MICHAEL C WALKER3 Filed as: MICHAEL RISKA | 203 MARKET ST STE 201 HARVE DE GRACE, MD 21078 | AFLAC | $4 | — | $4 | — |
| JASON D ELLIS3 Filed as: JASON ELLIS | 203 MARKET STREET STE 210 HAVRE DE GRACE, MD 21078 | AFLAC | $4 | — | $4 | — |
| CHRISTOPHER J ZELLNER3 Filed as: CHRISTOPHER ZELLNER | 918 ALDORA LN WAUNAKEE, WI 53597 | AFLAC | $4 | — | $4 | — |
| RYAN R KRUEGER3 Filed as: RYAN KRUEGER | 6234 TRANQUIL RIVER LN WAUSAU, WI 54401 | AFLAC | $3 | — | $3 | — |
| ADAM THOMAS GARDNER3 Filed as: ADAM GARDNER | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $2 | — | $2 | — |
| FRANCES SHAFFER3 | 14025 TOWER RD SMITHSBURG, MD 21783 | AFLAC | $2 | — | $2 | — |
| TIMOTHY ASBY3 | 11500 GOLDEN WILLOW CT ZIONSVILLE, IN 46077 | AFLAC | $1 | — | $1 | — |
| NATHAN BRONSON3 | W217 N5386 TAYLORS WOODS DR MENOMONEE FALLS, WI 53051 | AFLAC | $1 | — | $1 | — |
| ELIZABETH A LENZO3 | 701 ALBEROSKY WAY BATAVIA, IL 60510 | AFLAC | $1 | — | $1 | — |
| CHRISTINE LOGSLETT3 | 8318 ANNA AVE WIND LAKE, WI 53185 | AFLAC | $1 | — | $1 | — |
| SHADEL & ASSOCIATES LLC3 Filed as: SHADEL & ASSOCIATES INC | 126 HOPKINS ST NEPTUNE BEACH, FL 32266 | AFLAC | $1 | — | $1 | — |
| JEREMY A FELDMAN3 Filed as: JEREMY FELDMAN | 15324 SWEETBAY ST WOODBINE, MD 21797 | AFLAC | $0 | — | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRAIRIE STATES CLAIMS PROCESSING | Claims processing Service code 12 | 401 NORTH MICHIGAN AVE STE 2902 CHICAGO, ID 60611 | $43K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMIN | Contract Administrator Service code 13 | — | $6K |
| JOHNSON INSURANCE SERVICES LLC INS AGENT OR BROKER | Insurance agents and brokers Service code 22 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | $2K |
| COFINITY EIN 20-1274723 CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | — | $0 |
| FH GROUP CORP EIN 20-1736437 CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | — | $0 |
| GLOBALCARE EIN 31-1407689 CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | — | $0 |
| PHCS/MULTIPLAN EIN 39-1634080 CLAIMS PROCESSING | Claims processing; Other insurance fees and expenses Service code 12 | — | $0 |
| PREFERREDONE EIN 41-1846481 OTHER INS FEES | Other insurance fees and expenses Service code 73 | — | $0 |
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 | 184 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AFLAC | 93 | $0 |
| Vision(2 contracts, 2 carriers) | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 93 | $15K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORP | 105 | $324K |
| Other(2 contracts, 2 carriers) | WESTPORT INSURANCE CORP | 105 | $324K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.