| 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 | $615 | $30K | 3.06% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES | PO BOX 387 NEW RICHMOND, WI 54017 | DELTA DENTAL OF WISCONSIN | $9K | — | $9K | 10.27% |
| J A COUNTER & ASSOCIATES INC3 | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 15.27% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $935 | $935 | 3.51% |
| J A COUNTER & ASSOCIATES INC3 | 1477 S KNOWLES AVE STE 200 NEW RICHMOND, WI 54017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $5K | 17.98% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $862 | $862 | 3.40% |
| 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 | $2K | $707 | $3K | 20.08% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $472 | $472 | 3.40% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES | PO BOX 387 NEW RICHMOND, WI 54017 | WYSSTA INSURANCE COMPANY INC | $697 | — | $697 | 8.23% |
| 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 | $694 | $360 | $1K | 15.20% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $240 | $240 | 3.46% |
| 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 | $507 | $268 | $775 | 15.28% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $230 | $230 | 4.53% |
| 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 | $440 | $202 | $642 | 14.59% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $173 | $173 | 3.93% |
| HEARTLAND BENEFITS GROUP LLC4 | 3120 CASTLETON XING SUN PRAIRIE, WI 53590 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $127 | — | $127 | 13.00% |
| CHRISTINA L SUTTON4 Filed as: CHRISTINA MARIE LITTLEJOHN | 3960 107TH AVE N CLEARWATER, FL 33762 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $50 | — | $50 | 5.12% |
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 | 120 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 183 | $985K |
| Dental | DELTA DENTAL OF WISCONSIN | 97 | $91K |
| Vision | WYSSTA INSURANCE COMPANY INC | 60 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $27K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 52 | $25K |
| Other(6 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 119 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 183 | — |
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.