| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALSER INSURANCE LLC3 | 7700 FRANCE AVE SUITE 420N EDINA, MN 55435 | ALLSTATE | $7K | — | $7K | 13.38% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INS GRP LLC | P O BOX 207 MOSINEE, WI 54455 | ALLSTATE | $5K | — | $5K | 9.14% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVE STE 3A BAY ST LOUIS, MS 39520 | ALLSTATE | $2K | — | $2K | 3.84% |
| STEVEN SCULLION3 Filed as: STEVEN C SCULLION | 1101 W CLAIREMONT AVE STE 2E EAU CLAIRE, WI 54701 | ALLSTATE | $2K | — | $2K | 3.51% |
| HOLLY DOOLEY3 | 1101 W CLAIREMONT AVE STE 2E EU CLAIRE, WI 54701 | ALLSTATE | $2K | — | $2K | 3.16% |
| MARY KLINER3 | 15237 224TH AVE BLOOMER, WI 54724 | ALLSTATE | $651 | — | $651 | 1.19% |
| DANIEL BARNUM3 | 1817 KENDALL ST STE B EU CLAIRE, WI 54703 | ALLSTATE | $609 | — | $609 | 1.11% |
| MARIO RACANELLI3 | 4713 FAIRFAX ST EAU CLAIRE, WI 54701 | ALLSTATE | $361 | — | $361 | 0.66% |
| NICHOLAS KIEKOW3 | N53W33177 LINDEN CIRCLE E NASHOTAH, WI 53058 | ALLSTATE | $251 | — | $251 | 0.46% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC CO | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 15.01% |
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 | 401 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 401 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other(2 contracts, 2 carriers) | ALLSTATE | 401 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 401 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.