| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J A COUNTER & ASSOCIATES INC3 Filed as: JA COUNTER & ASSOCIATES INC | PO BOX 387 NEW RICHMOND, WI 54017 | MEDICA INSURANCE COMPANY | $30K | $650 | $30K | 3.07% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | PO BOX 387 NEW RICHMOND, WI 54017 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 9.90% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $534 | $4K | 11.37% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $544 | $544 | 1.70% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 11.99% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES | 1477 S KNOWLES AVE NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $380 | $3K | 17.56% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $351 | $351 | 2.37% |
| PATRICIA L OBERMUELLER3 | 1421 N BROADWAY STE 108 MENOMONIE, WI 54751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 18.92% |
| MICHAEL BECK3 Filed as: MICHAEL J BECK | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $379 | — | $379 | 2.85% |
| MICHAEL A PEDERSON3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $329 | — | $329 | 2.47% |
| SAMANTHA C CORTELAZZO-ABBATE3 Filed as: SAMANTHA J MICHAELSON | 101 N. FARWELL STREET STE 103 EAU CLAIRE, WI 54703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $185 | — | $185 | 1.39% |
| ADAM THOMAS GARDNER3 Filed as: ADAM T GARDNER | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $143 | — | $143 | 1.07% |
| JASON P SCZEPANIAK3 | 4001 FELLAND RD SUITE 106 MADISON, WI 53718 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | — | $40 | 0.30% |
| KARRIE L STERKEN3 | 55 S PARK STREET ZEELAND, MI 49464 | CONTINENTAL AMERICAN INSURANCE COMPANY | $40 | — | $40 | 0.30% |
| JEREMY KOOI3 | 304 W PARKVIEW ST COTTAGE GROVE, WI 53527 | CONTINENTAL AMERICAN INSURANCE COMPANY | $26 | — | $26 | 0.20% |
| ROSS C NELSON3 | 1403 WIMBLETON WAY WAUNAKEE, WI 53597 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | — | $22 | 0.17% |
| KNUTE NELSON3 Filed as: KNUTE T NELSON | 3920 KIPLING AVE MINNEAPOLIS, MN 55416 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | — | $5 | 0.04% |
| CHRISTOPHER J ZELLNER3 | 4001 FELLAND ROAD STE 106 MADISON, WI 53718 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | — | $3 | 0.02% |
| CHRISTINE LOGSLETT3 Filed as: CHRISTINE M LOGSLETT | 300 N CORPORATE DRIVE STE 300 BROOKFIELD, WI 53045 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES | PO BOX 387 NEW RICHMOND, WI 54017 | WYSSTA INSURANCE COMPANY INC | $879 | — | $879 | 8.49% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER AND ASSOCIATES INC | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $814 | $140 | $954 | 11.72% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $142 | $142 | 1.74% |
| CHRISTINA L SUTTON4 Filed as: CHRISTINA MARIE LITTLEJOHN | 3960 107TH AVE N CLEARWATER, FL 33762 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $390 | — | $390 | 20.98% |
| HEARTLAND BENEFITS GROUP LLC4 | 3120 CASTLETOWN XING SUN PRAIRIE, WI 53590 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $73 | — | $73 | 3.93% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $328 | $328 | 820.00% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $321 | $321 | 802.50% |
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 | 165 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 167 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 248 | $985K |
| Dental | DELTA DENTAL OF WISCONSIN | 128 | $104K |
| Vision | WYSSTA INSURANCE COMPANY INC | 81 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $8K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 165 | $32K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 66 | $40 |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 164 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 248 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.