| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KAREN HAGEN/BAER INSURANCE SERVICES3 | PO BOX 46490 MADISON, WI 53744 | DEAN HEALTH PLAN INC | $24K | — | $24K | 1.81% |
| BAER INSURANCE3 Filed as: BAER INSURANCE SERVICES LLC | 9701 BRADER WAY SUITE 100 MIDDLETON, WA 53562 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.78% |
| BAER INSURANCE3 Filed as: BAER INSURANCE SERVICES LLC | 9701 BRADER WAY SUITE 100 MIDDLETON, WI 53562 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 14.39% |
| BAER INSURANCE3 Filed as: BAER INSURANCE SERVICES LLC | 9701 BRADER WAY SUITE 100 MIDDLETON, WI 53562 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $937 | — | $937 | 5.60% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53708 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $297 | $3 | $300 | 1.79% |
| HAMBY, JAMES, WESLEY3 | 503 FORREST PARK COURT MADISON, AL 35758 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $75 | — | $75 | 0.45% |
| HAGEN KAREN J3 | PO BOX 46490 MADISON, WI 53744 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $2K | — | $2K | 10.00% |
| BAER INSURANCE3 Filed as: BAER INSURANCE SERVICES LLC | 9701 BRADER WAY SUITE 100 MIDDLETON, WI 53562 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
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 | 257 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 264 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DEAN HEALTH PLAN INC | 162 | $1.4M |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 162 | $17K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 255 | $52K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 46 | $17K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 255 | $52K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 255 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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.