| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INSURANCE CENTER3 | 701 SAND LAKE RD ONALASKA, WI 54650 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $30K | — | $30K | 1.70% |
| T I C INC3 Filed as: T.I.C., INC. | 701 SAND LAKE RD. ONALASKA, WI 54650 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 6.49% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 15.00% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 15.00% |
| TIC INC3 Filed as: TIC INC. | 701 SAND LAKE RD. ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| T.I.C. INC AKA THE INSURANCE CENTER3 Filed as: T.I.C INC, DBA THE INSURANCE CENTER | 701 SAND LAKE ROAD ONALASKA, WI 54650 | NATIONAL VISION ADMINISTRATORS, L.L.C. | $949 | — | $949 | 5.00% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $656 | — | $656 | 15.00% |
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 | 307 | 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) | 309 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 394 | $1.8M |
| Dental | DELTA DENTAL OF WISCONSIN | 218 | $150K |
| Vision | NATIONAL VISION ADMINISTRATORS, L.L.C. | 389 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $52K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 101 | $62K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $29K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 394 | $1.8M |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 313 | $114K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 394 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.