| 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 | $6K | $0 | $6K | 0.68% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | ANTHEM LIFE INSURANCE COMPANY | $267 | $0 | $267 | 0.68% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | DELTA DENTAL OF WISCONSIN | $3K | $0 | $3K | 9.10% |
| JOHNSON INSURANCE SERVICES LLC3 Filed as: JOHNSON INSURANCE SERVICES, LLC | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 12.11% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DRIVE MOUNT PLEASANT, WI 53406 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.05% |
| 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 | $107 | $0 | $107 | 1.06% |
| NORMA JO SMITH3 | 3617 HUNTERS GLEN ROAD ABILENE, TX 79605 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $98 | $0 | $98 | 0.97% |
| USI INSURANCE SERVICES LLC3 | 613 RIVER PARK ROAD BELMONT, NC 28012 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $94 | $0 | $94 | 0.93% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DRIVE, SUITE 100 MOUNT PLEASANT, WI 53406 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62819 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $29 | $29 | 0.29% |
| UNKNOWN3 | UNKNOWN DENMARK, WI 54208 | WYSSTA INSURANCE COMPANY INC | $531 | $0 | $531 | 8.01% |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 71 | $850K |
| Dental | DELTA DENTAL OF WISCONSIN | 66 | $34K |
| Vision | WYSSTA INSURANCE COMPANY INC | 53 | $7K |
| Life insurance(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 197 | $73K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 197 | $34K |
| Long-term disability(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 197 | $63K |
| Prescription drug | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | 71 | $850K |
| Other(3 contracts, 3 carriers) | ANTHEM LIFE INSURANCE COMPANY | 197 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 197 | — |
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.