| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $7K | $491 | $8K | 1.21% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | ANTHEM LIFE INSURANCE COMPANY | $720 | $49 | $769 | 1.21% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $269 | $18 | $287 | 1.21% |
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVENUE EAST SUITE 1500 CLEVELAND, OH 44114 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $272 | $0 | $272 | 1.60% |
| NORMA JO SMITH3 | 3617 HUNTERS GLEN ROAD ABILENE, TX 79605 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $160 | $0 | $160 | 0.94% |
| USI INSURANCE SERVICES LLC3 | 613 RIVER PARK ROAD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $153 | $0 | $153 | 0.90% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $34 | $34 | 0.20% |
| USI INSURANCE SERVICES LLC3 | 14601 27TH AVENUE NORTH, SUITE 101 PLYMOUTH, MN 55447 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.09% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $0 | $10 | 0.06% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.03% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $58 | $0 | $58 | 3.25% |
| THE JAMES B OSWALD COMPANY3 | 1100 SUPERIOR AVENUE EAST SUITE 1500 CLEVELAND, OH 44114 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11 | $0 | $11 | 0.62% |
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 | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 48 | $636K |
| Dental | BLUE CROSS BLUE SHIELD OF WISCONSIN | 100 | $24K |
| Vision | BLUE CROSS BLUE SHIELD OF WISCONSIN | 100 | $24K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 152 | $80K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 47 | $17K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 152 | $63K |
| Prescription drug | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 48 | $636K |
| Other(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 152 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 152 | — |
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.