| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 8040 EXCELSIOR DRIVE MADISON, WI 53717 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $17K | — | $17K | 4.81% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP, LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | DEAN HEALTH PLAN INC | $9K | — | $9K | 2.96% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GRP LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $35 | $35 | 0.25% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GRP LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $30 | $30 | 0.23% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GRP LLC | 711 EISENHOWER DR KIMBERLY, WI 54136 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $0 | $22 | $22 | 0.21% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DRIVE KIMBERLEY, WI 54136 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | $425 | — | $425 | 9.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | 2801 HOOVER RD STEVENS POINT, WI 54481 | $5K |
| ASSOCIATED FINANCIAL GROUP LLC INSURANCE AGENT | Insurance agents and brokers Service code 22 | 8040 EXCELSIOR DRIVE MADISON, WI 53717 | $277 |
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 | 117 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 109 | $647K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN, INC. | 62 | $5K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 201 | $24K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 116 | $13K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 59 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 201 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.