| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INS SER LLC | 318 S WASHINGTON ST STE 200 GREEN BAY, WA 543014242 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | $17K | — | $17K | 3.67% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SER LLC | 555 MAIN ST RACINE, WA 534031000 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | $1K | $5K | $6K | 1.29% |
| HUMANA MARKETPOINT INC3 | 500 W MAIN NCT 28 LOUISVILLE, KY 402022946 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | $616 | — | $616 | 0.13% |
| JOHNSON INS SERVICES LLC3 | 555 MAIN ST. STE. 291 RACINE, WI 53403 | UNION SECURITY INSURANCE COMPANY | $12K | $339 | $12K | 11.11% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES | 555 MAIN STREET STE 291 RACINE, WI 53403 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $3K | — | $3K | 10.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA | Contract Administrator Service code 13 | PO BOX 828 STEVENS POINT, WI 54481 | $12K |
| JOHNSON INSURANCE SERVICES LLC EIN 56-2435265 INSURANCE AGENT BROKER | Insurance agents and brokers Service code 22 | 555 MAIN ST STE 291 RACINE, WI 53403 | $2K |
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 | 318 | 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) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | 242 | $473K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 691 | $28K |
| Life insurance(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | 318 | $585K |
| Short-term disability(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | 318 | $585K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 318 | $112K |
| Other(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CO. | 318 | $585K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 691 | — |
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.