| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $190K | $5K | $195K | 1.81% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | SUN LIFE ASSURANCE COMPANY OF CANADA | $29K | $0 | $29K | 4.72% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23K | $180 | $23K | 3.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 650 EAST CARMEL DRIVE, SUITE 400 CARMEL, IN 46032 | SUN LIFE ASSURANCE COMPANY OF CANADA | $18K | $0 | $18K | 2.94% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 4TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $0 | $1K | 0.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | DELTA DENTAL OF WISCONSIN | $42K | $0 | $42K | 8.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, SUITE 1000 ROLLING MEADOWS, IL 60008 | WYSSTA INSURANCE COMPANY INC | $8K | $0 | $8K | 8.96% |
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 | 1,516 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,516 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 1,589 | $10.8M |
| Dental | DELTA DENTAL OF WISCONSIN | 821 | $488K |
| Vision | WYSSTA INSURANCE COMPANY INC | 792 | $84K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,327 | $616K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,327 | $616K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,327 | $616K |
| Prescription drug | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 1,589 | $10.8M |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,327 | $616K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,589 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.