| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WALSER INSURANCE LLC3 | 4401 AMERICAN BLVD W BLOOMINGTON, MN 55437 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $702 | — | $702 | 1.75% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INS GROUP LLC | P O BOX 207 MOSINEE, WI 54455 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $434 | — | $434 | 1.08% |
| STEVEN SCULLION3 | 1101 W CLAIREMONT AVENUE SUITE 2E EAU CLAIRE, WI 54701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $189 | — | $189 | 0.47% |
| CHARLOTTE R SANTA CRUZ3 | 718 DUNBAR AVENUE SUITE 3A BAY ST LOUIS, MS 39520 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $180 | — | $180 | 0.45% |
| HOLLY DOOLEY3 | 1101 W CLAIREMONT AVENUE SUITE 2E EAU CLAIRE, WI 54701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $159 | — | $159 | 0.40% |
| DANIEL BARNUM3 | 1311 PIEDMONT RD EAU CLAIRE, WI 54703 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $115 | — | $115 | 0.29% |
| MARY KLINER3 | 15237 224TH AVENUE BLOOMER, WI 54724 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $104 | — | $104 | 0.26% |
| MARIO RACANELLI3 Filed as: MARIO RACANELLO | 3717 FAIRFAX STREET EAU CLAIRE, WI 54701 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $71 | — | $71 | 0.18% |
| NICHOLAS KIEKOW3 | N53W33177 LINDEN CIRCLE EAST NASHOTAH, WI 53058 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $27 | — | $27 | 0.07% |
| ERIC W WENGER3 | 17909 HIGHWAY 7 MINNETONKA, MN 55345 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $15 | — | $15 | 0.04% |
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 | 106 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 106 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 106 | — |
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.