| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MELISSA WIDUCKI3 | 311 FINANCIAL WAY STE 220 WAUSAU, WI 54401 | AFLAC | $4K | $249 | $5K | 7.32% |
| BEJAMIN BAKER3 | 5351 BROADWAY ST NEWALD, WI 54511 | AFLAC | $914 | $45 | $959 | 1.48% |
| RICKY E ROBINSON3 Filed as: RICKY ROBINSON | 934 SWEENEY DR STE ONE HAGERSTOWN, MD 21740 | AFLAC | $676 | $32 | $708 | 1.10% |
| ALICE MAGUIRE3 | 4512 TWIN PINES LN WESTON, WI 54476 | AFLAC | $604 | $79 | $683 | 1.06% |
| KYLE G WHELTON3 | 517 FISHERMANS ROW SHEBOYGAN, WI 53081 | AFLAC | $317 | — | $317 | 0.49% |
| BRIAN S LOWE3 | 920 SARDIS DR BOAZ, AL 35956 | AFLAC | $233 | $69 | $302 | 0.47% |
| DAVID R PONTA3 Filed as: DAVID PONTA | 145 S DUKE ST STE B YORK, PA 17401 | AFLAC | $300 | — | $300 | 0.46% |
| LISA M LOUDIN3 Filed as: LISA LOUDIN | 2129 GUILFORD RD ROCKFORD, IL 61107 | AFLAC | $292 | — | $292 | 0.45% |
| ALISON M MORROW3 Filed as: ALISON MORROW | 311 FINANCIAL WAY STE 220 WAUSAU, WI 54401 | AFLAC | $204 | — | $204 | 0.32% |
| DAVID W BRANDT3 Filed as: DAVID BRANDT | 6908 FOX CHASE RD NEW MARKET, MD 21774 | AFLAC | $174 | — | $174 | 0.27% |
| TAMMY ANN BACKHAUS3 | 179 MILL ST CAMPBELLSPORT, WI 53010 | AFLAC | $147 | — | $147 | 0.23% |
| LYNN KARL3 | W10030 PARKSIDE LN ANTIGO, WI 54409 | AFLAC | $142 | — | $142 | 0.22% |
| SALLY ANN WHITE3 | 3051 PROGRESS WAY STE 204 KAUKAUNA, WI 54130 | AFLAC | $71 | $52 | $123 | 0.19% |
| JOHNSON INSURANCE SERVICES LLC3 | 318 S WASHINGTON ST STE 200 GREEN BAY, WI 53401 | AFLAC | $92 | — | $92 | 0.14% |
| BETH LUANNE KIMBROUGH3 Filed as: BETH KIMBROUGH | 6750 N ANDREWS AVE STE 200 FT LAUDERDALE, FL 33309 | AFLAC | $91 | — | $91 | 0.14% |
| BRANDT INC3 | 360 LOUCKS RD STE 305 YORK, PA 17404 | AFLAC | $87 | — | $87 | 0.13% |
| BRYAN FISH3 | 4050 CANDLE LIGHT DR DAYTON, MD 21036 | AFLAC | $76 | $7 | $83 | 0.13% |
| MICHAEL J SKOFF3 Filed as: MICHAEL SKOFF | 815 N CHURCH ST ROCKFORD, IL 61103 | AFLAC | $75 | — | $75 | 0.12% |
| DEWAYNE D RAY3 | PO BOX 41 GUNTERSVILLE, AL 35976 | AFLAC | $52 | $16 | $68 | 0.11% |
| PAUL W DESPIRITO3 | 3051 PROGESS WAY STE 204 KAUKAUNA, WI 54130 | AFLAC | $48 | $12 | $60 | 0.09% |
| PETER J TEKAMPE3 | 815 N CHURCH ST ROCKFORD, IL 61103 | AFLAC | $49 | — | $49 | 0.08% |
| SHANNON A LADING3 | 738 W 4TH ST APPLETON, WI 54914 | AFLAC | $37 | $12 | $49 | 0.08% |
| ROBERT J DONOHUE3 Filed as: ROBERT DONOHUE | 808 FAIRWAY DRIVE MOSINEE, WI 54455 | AFLAC | $47 | — | $47 | 0.07% |
| KRISTIN L ARVIGO3 | 917 WOODLANE AVE ROCKFORD, IL 61107 | AFLAC | $44 | — | $44 | 0.07% |
| KELVIN MICHAEL RICE3 | 529 EDINBURGH WAY DOTHAN, AL 36305 | AFLAC | $24 | $16 | $40 | 0.06% |
| JAMEY MILLER INC3 | 2202 57TH ST SE AUBURN, WA 98092 | AFLAC | $40 | — | $40 | 0.06% |
| MARK JOHNSTON3 | 124 UNDERKE TER HEDGESVILLE, WV 25427 | AFLAC | $31 | — | $31 | 0.05% |
| JAMIE R LAUENSTEIN3 | WEST 3082 CEDAR RD STE G EDEN, WI 53019 | AFLAC | $27 | — | $27 | 0.04% |
| TRICIA BLAIR3 | 311 FINANCIAL WAY STE 220 WAUSAU, WI 54401 | AFLAC | $26 | — | $26 | 0.04% |
| GLEN T SCHWEIKERT3 Filed as: GLEN SCHWEIKERT | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $23 | — | $23 | 0.04% |
| JEFFREY A. MUSSOLINO3 Filed as: JEFFREY A MUSSOLINO | 805 HAMILTON BLVD HAGERSTOWN, MD 21742 | AFLAC | $20 | — | $20 | 0.03% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $17 | — | $17 | 0.03% |
| JEFFREY A. MUSSOLINO3 Filed as: JEFFREY A MUSSOLINO | 724 POTOMAC AVE HAGERSTOWN, MD 21740 | AFLAC | $17 | — | $17 | 0.03% |
| RAMON PURVIS3 | 380 VALLEY DR FAYETTEVILLE, PA 17222 | AFLAC | $15 | — | $15 | 0.02% |
| PATRICK KREFT3 | 107 EDDY RD EDGAR, WI 54426 | AFLAC | $15 | — | $15 | 0.02% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 23 CROYDON LN OAK BROOK, IL 60523 | AFLAC | $15 | — | $15 | 0.02% |
| DENNIS J CASSENS3 Filed as: DENNIS CASSENS | 4646 E MARRILL RD STE 1 BYRON, IL 61010 | AFLAC | $11 | — | $11 | 0.02% |
| SAMANTHA J BREUER3 | E4355 PINEWOOD CIR ELEVA, WI 54738 | AFLAC | $11 | — | $11 | 0.02% |
| IRENE E BROOKS3 Filed as: IRENE BROOKS | 101 COPPER BEECH LN WOMELSDORF, PA 19567 | AFLAC | $10 | — | $10 | 0.02% |
| STEVEN T SPEICHINGER3 Filed as: STEVEN SPEICHINGER | 3008 CHRISTIAN AVE WAUSAU, WI 54401 | AFLAC | $10 | — | $10 | 0.02% |
| TRICIA SCHOENECK3 | 3462 COLUMBUS LAKE RD EAGLE RIVER, WI 54521 | AFLAC | $10 | — | $10 | 0.02% |
| KIMBERLY L LUSHBAUGH3 Filed as: KIMBERLY LUSHBAUGH | 14 CATAWBA CIRCLE HAGERSTOWN, MD 21742 | AFLAC | $10 | — | $10 | 0.02% |
| JEREMY KOOI3 | 270 SHAKERAGE ST MINERAL POINT, WI 53565 | AFLAC | $8 | — | $8 | 0.01% |
| PETER J TEKAMPE3 | 6739 HARTWIG DR CHERRY VALLEY, IL 61016 | AFLAC | $7 | — | $7 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL WALKER | 203 MARKET ST STE 201 HARVRE DE GRACE, MD 21078 | AFLAC | $6 | — | $6 | 0.01% |
| WILLIAM F MURRAY III3 Filed as: WILLIAM MURRAY III | 1298 SAINT PATRICK WAY SUN PRAIRIE, WI 53590 | AFLAC | $5 | — | $5 | 0.01% |
| ROSS C NELSON3 Filed as: ROSS NELSON | 440 REGENCY PARKWAY DR STE 234 OMAHA, NE 68114 | AFLAC | $5 | — | $5 | 0.01% |
| MICHAEL C WALKER3 Filed as: MICHAEL RISKA | 203 MARKET ST STE 201 HARVE DE GRACE, MD 21078 | AFLAC | $4 | — | $4 | 0.01% |
| JASON D ELLIS3 Filed as: JASON ELLIS | 203 MARKET STREET STE 210 HAVRE DE GRACE, MD 21078 | AFLAC | $4 | — | $4 | 0.01% |
| KELVIN MICHAEL RICE3 | 623 WESTBROOK RD DOTHAN, AL 36303 | AFLAC | $4 | — | $4 | 0.01% |
| CHRISTOPHER J ZELLNER3 Filed as: CHRISTOPHER ZELLNER | 918 ALDORA LN WAUNAKEE, WI 53597 | AFLAC | $3 | — | $3 | 0.00% |
| ARON D TERAN3 Filed as: ARON TERAN | 3812 CARRIAGE HILL DR FREDERICK, MD 21704 | AFLAC | $3 | — | $3 | 0.00% |
| FRANCES SHAFFER3 | 14025 TOWER RD SMITHSBURG, MD 21783 | AFLAC | $2 | — | $2 | 0.00% |
| TIMOTHY ASBY3 | 11500 GOLDEN WILLOW CT ZIONSVILLE, IN 46077 | AFLAC | $2 | — | $2 | 0.00% |
| ELIZABETH A LENZO3 | 701 ALBEROSKY WAY BATAVIA, IL 60510 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTINE LOGSLETT3 | 8318 ANNA AVE WIND LAKE, WI 53185 | AFLAC | $1 | — | $1 | 0.00% |
| SHADEL & ASSOCIATES LLC3 Filed as: SHADEL & ASSOCIATES INC | 126 HOPKINS ST NEPTUNE BEACH, FL 32266 | AFLAC | $1 | — | $1 | 0.00% |
| ADAM THOMAS GARDNER3 Filed as: ADAM GARDNER | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $1 | — | $1 | 0.00% |
| JEREMY A FELDMAN3 Filed as: JEREMY FELDMAN | 12391 HIDDEN BAY DR BERLIN, MD 21811 | AFLAC | $1 | — | $1 | 0.00% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 318 SOUTH WASHINGTON STREET GREEN BAY, WI 54301 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $2K | — | $2K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRAIRIE STATES CLAIMS PROCESSING | Claims processing Service code 12 | 401 NORTH MICHIGAN AVE STE 2902 CHICAGO, ID 60611 | $21K |
| 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 |
| FH GROUP CORP EIN 20-1736437 CLAIMS PROCESSING | Claims processing; Other insurance fees and expenses Service code 12 | — | $0 |
| FIRST HEALTH EIN 20-1274723 CLAIMS PROCESSING | Other insurance fees and expenses; Claims processing Service code 12 | — | $0 |
| GLOBALCARE EIN 31-1407689 CLAIMS PROCESSING | Claims processing; Other insurance fees and expenses 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 | 100 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 7 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 108 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 99 | $16K |
| Short-term disability | AFLAC | 105 | $65K |
| Stop-loss / reinsurancereinsurance | WESTPORT INSURANCE CORP | 100 | $315K |
| Other(2 contracts, 2 carriers) | WESTPORT INSURANCE CORP | 105 | $380K |
| 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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.