| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 53725 | DEAN HEALTH PLAN, INC. | $4K | — | $4K | 3.25% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME | 740 REGENT ST - STE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 10.95% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK - STE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.54% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC. | 740 REGENT ST - STE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $898 | — | $898 | 1.49% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME | 740 REGENT ST -SUITE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 15.80% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK - STE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $666 | $666 | 2.55% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | 740 REGENT ST - SUITE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $641 | — | $641 | 2.45% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME | 740 REGENT ST - STE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $905 | $3K | 17.96% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK - STE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $453 | $453 | 2.62% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC. | 740 REGENT ST - STE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $395 | — | $395 | 2.29% |
| INGENIUM PRIME INC3 Filed as: INGENIUM PRIME | 740 REGENT ST - STE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $701 | $2K | 13.71% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK -STE A BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $351 | $351 | 2.60% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP, INC. | 740 REGENT STREET-STE 400 MADISON, WI 53715 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $199 | — | $199 | 1.47% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | N25 W23050 PAUL ROAD PEWAUKEE, WI 53072 | WYSSTA INSURANCE COMPANY, INC. | $830 | — | $830 | 8.00% |
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 | 220 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | DEAN HEALTH PLAN, INC. | 27 | $133K |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 82 | $10K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $31K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $60K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $26K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 217 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 217 | — |
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.