| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALSER INSURANCE LLC3 | 4401 AMERICAN BLVD W BLOOMINGTON, MN 55437 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $267 | — | $267 | 1.63% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INS GRP LLC | PO BOX 207 MOSINEE, WI 54455 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $195 | — | $195 | 1.19% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $79 | — | $79 | 0.48% |
| STEVEN SCULLION3 | 1101 W CLAIREMONT AVE STE 2E EAU CLAIRE, WI 54701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $63 | — | $63 | 0.38% |
| HOLLY DOOLEY3 | 1101 W CLAIREMONT AVE STE 2E EAU CLAIRE, WI 54701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $47 | — | $47 | 0.29% |
| MARY KLINER3 | 15237 224TH AVE BLOOMER, WI 54724 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $35 | — | $35 | 0.21% |
| MARIO RACANELLI3 | 3717 FAIRFAX STREET EAU CLAIRE, WI 54701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $34 | — | $34 | 0.21% |
| DANIEL BARNUM3 | 1311 PIEDMONT RD EAU CLAIRE, WI 54703 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $29 | — | $29 | 0.18% |
| NICHOLAS KIEKOW3 | N53W33177 LINDEN CIRCLE EAST NASHOTAH, WI 53058 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $10 | — | $10 | 0.06% |
| ERIC W WENGER3 | 17909 HIGHWAY 7 MINNETONKA, MN 55345 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $3 | — | $3 | 0.02% |
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 | 785 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 56 | $16K |
| Other | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 56 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,382 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
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.