| 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 | $7K | $0 | $7K | 0.79% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | ANTHEM LIFE INSURANCE COMPANY | $398 | $0 | $398 | 0.79% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $3K | $0 | $3K | 8.87% |
| THE JAMES B OSWALD COMPANY3 Filed as: JAMES B. OSWALD COMPANY | 1100 SUPERIOR AVENUE EAST SUITE 1500 CLEVELAND, OH 44114 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $257 | $0 | $257 | 1.42% |
| NORMA JO SMITH3 | 3617 HUNTERS GLEN ROAD ABILENE, TX 79605 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $158 | $0 | $158 | 0.87% |
| USI INSURANCE SERVICES LLC3 | 613 RIVER PARK ROAD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $149 | $0 | $149 | 0.82% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, VA 53406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $139 | $0 | $139 | 0.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $40 | $40 | 0.22% |
| USI INSURANCE SERVICES LLC3 | PO BOX 601478 CHARLOTTE, NC 28260 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | $0 | $18 | 0.10% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.02% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $48 | $0 | $48 | 3.03% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 72 | $847K |
| Dental | BLUE CROSS BLUE SHIELD OF WISCONSIN | 58 | $30K |
| Vision | BLUE CROSS BLUE SHIELD OF WISCONSIN | 58 | $30K |
| Life insurance(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 161 | $68K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 42 | $18K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 161 | $50K |
| Prescription drug | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 72 | $847K |
| Other(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 161 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.