| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NATIONAL INSURANCE SERV OF WISC INC3 | 250 SOUTH EXECUTIVE DRIVE SUITE 300 BROOKFIELD, WI 530054273 | MADISON NATIONAL LIFE INSURANCE COMPANY INC | $15K | — | $15K | 12.00% |
| NATIONAL INSURANCE SERV OF WI INC3 Filed as: NATIONAL INSURANCE SERV OF WI, INC. | 14852 SCENIC HEIGHTS RD STE 210 EDEN PRAIRIE, MN 553442289 | DELTA DENTAL OF MINNESOTA | $2K | — | $2K | 3.01% |
| NATIONAL INSURANCE SERVICES OF WI3 Filed as: NATIONAL INSURANCE SVCS OF WI | 250 SOUTH EXECUTIVE DRIVE BROOKFIELD, WI 530054273 | MINNESOTA LIFE INSURANCE COMPANY | $4K | — | $4K | 13.00% |
| OCHS INC3 Filed as: OCHS INC. | 18-3789 400 ROBERT ST NORTH ST. PAUL, MN 551012098 | MINNESOTA LIFE INSURANCE COMPANY | — | $4K | $4K | 12.60% |
| TRICOR, INC3 Filed as: TRICOR INC | 230 W CHERRY ST LANCASTER, WI 538131629 | AMERITAS LIFE INSURANCE CORP. | $946 | $14 | $960 | 9.20% |
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 | 190 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 120 | $58K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 116 | $10K |
| Life insurance | MINNESOTA LIFE INSURANCE COMPANY | 219 | $33K |
| Long-term disability | MADISON NATIONAL LIFE INSURANCE COMPANY INC | 175 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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.