| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | NETWORK HEALTH PLAN | $41K | $6K | $47K | 6.19% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | HUMANA INSURANCE COMPANY | $3K | $0 | $3K | 3.96% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $6K | 14.55% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY, STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $903 | $903 | 2.05% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $584 | $2K | 20.80% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY, STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $195 | $195 | 1.94% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $909 | $0 | $909 | 10.00% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $429 | $1K | 21.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY, STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $143 | $143 | 2.05% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $621 | $381 | $1K | 16.15% |
| PATRIOT GROWTH INSURANCE SERVICES3 | 4365 SOUTHWEST FWY, STE 750 HOUSTON, TX 77027 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $127 | $127 | 2.05% |
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 | 152 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NETWORK HEALTH PLAN | 132 | $755K |
| Dental | HUMANA INSURANCE COMPANY | 119 | $81K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 122 | $9K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $16K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $44K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $7K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 166 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
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.