| 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 | $67K | $0 | $67K | 4.10% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | PO BOX 389 MENASHA, WI 54952 | DELTA DENTAL OF WISCONSIN | $7K | $0 | $7K | 4.80% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 10.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.85% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 19.97% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $379 | $379 | 1.81% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $2K | $0 | $2K | 10.51% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $675 | $3K | 20.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $245 | $245 | 1.85% |
| MCCLONE AGENCY INC3 Filed as: THE MCCLONE AGENCY INC. | 150 MAIN STREET, STE 300 MENASHA, WI 54952 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $598 | $2K | 15.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GI GEORGE PARENT LP | 501 OFFICE CENTER DR, STE 215 FORT WASHINGTON, PA 19034 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $217 | $217 | 1.84% |
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 | 279 | 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) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | NETWORK HEALTH PLAN | 211 | $1.6M |
| Dental | DELTA DENTAL OF WISCONSIN | 215 | $142K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 412 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $84K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 291 | $13K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 295 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 412 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.