| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE CENTER3 | 701 SAND LAKE RD ONALASKA, WI 54650 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $28K | — | $28K | 1.51% |
| T I C INC3 Filed as: T.I.C., INC. | 701 SAND LAKE RD. ONALASKA, WI 54650 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 6.61% |
| T I C INC3 Filed as: T I C INC. | 701 SAND LAKE RD ONALASKA, WI 54650 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $19K | — | $19K | 20.50% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $2K | $13K | 18.16% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 2.71% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 19.13% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 3.54% |
| TIC INC3 Filed as: TIC INC. | 701 SAND LAKE RD. ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $6K | 18.18% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $859 | $859 | 2.72% |
| T I C INC3 Filed as: T.I.C, INC | 701 SAND LAKE ROAD ONALASKA, WI 54650 | WYSSTA INSURANCE COMPANY INC | $959 | — | $959 | 5.48% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $697 | $153 | $850 | 18.28% |
| NATIONAL BENEFIT CENTER3 | 23825 COMMERCE PARK BEACHWOOD, OH 44122 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $131 | $131 | 2.82% |
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 | 330 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 333 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 422 | $1.9M |
| Dental | DELTA DENTAL OF WISCONSIN | 234 | $152K |
| Vision | WYSSTA INSURANCE COMPANY INC | 172 | $17K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 327 | $52K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $74K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 327 | $32K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 422 | $1.9M |
| Other(4 contracts, 2 carriers) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 327 | $217K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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."
No prospect flags tripped on this filing.