| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE CENTER3 | 701 SAND LAKE ROAD ONALASKA, WI 546502442 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $24K | — | $24K | 1.39% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WA 546502442 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 4.88% |
| JANICE L WAVRA - 53957S3 | 701 SAND LAKE ROAD ONALASKA, WI 54650 | KANSAS CITY LIFE INSURANCE COMPANY | $13K | — | $13K | 11.36% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3K | — | $3K | 15.99% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 15.39% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 546502442 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 7.94% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 19.13% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $409 | — | $409 | 39.71% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $50 | — | $50 | 9.86% |
| TIC INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $198 | — | $198 | 50.13% |
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 | 191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 280 | $1.8M |
| Dental | DELTA DENTAL OF WISCONSIN | 123 | $125K |
| Vision | WYSSTA INSURANCE COMPANY INC | 99 | $13K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 201 | $111K |
| Short-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 201 | $111K |
| Long-term disability | KANSAS CITY LIFE INSURANCE COMPANY | 201 | $111K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 280 | $1.8M |
| Other(7 contracts, 2 carriers) | KANSAS CITY LIFE INSURANCE COMPANY | 201 | $152K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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.