| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN STREET STE 320 RACINE, WI 53402 | UNITY HEALTH PLANS INSURANCE CORPORATION | $27K | — | $27K | 2.34% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN STREET DUBUQUE, IA 52001 | UNITY HEALTH PLANS INSURANCE CORPORATION | $2K | — | $2K | 0.19% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DR MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $1K | $14K | 11.20% |
| COTTINGHAM & BUTLER3 Filed as: COTINGHAM AND BUTLER | 800 MAIN STREET DUBUQUE, IA 52001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $476 | $3K | 2.86% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM AND BUTLER | 800 MAIN STREET DUBUQUE, IA 52001 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 5.20% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITY HEALTH PLANS INSURANCE CORPORATION | 114 | $1.1M |
| Dental | DELTA DENTAL OF WISCONSIN | 110 | $119K |
| Vision | DELTA DENTAL OF WISCONSIN | 110 | $119K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $121K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $121K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $121K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 129 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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.