| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP, INC. | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | PREVEA360 HEALTH PLAN | $57K | — | $57K | 8.54% |
| PATRICIA L OBERMUELLER3 Filed as: PATRICIA OBERMUELLER | 1421 BROADWAY ST N STE 108 MENOMONIE, WI 54751 | AFLAC | $11K | $2K | $14K | 8.44% |
| MICHAEL BECK3 | 645 8TH ST N HUDSON, WI 54016 | AFLAC | $5K | $831 | $6K | 3.66% |
| MICHAEL A PEDERSON3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $2K | $828 | $3K | 1.84% |
| SHELLY VANYO INVESTMENTS INC3 Filed as: SHELLY VANYO INVESTMENT, INC. | N6926 495TH ST MENOMONIE, WI 54751 | AFLAC | $2K | $731 | $3K | 1.74% |
| CHARLOTTE HEIMER3 | 2607 50TH AVE WOODVILLE, WI 54028 | AFLAC | $1K | $508 | $2K | 1.23% |
| TAD HOWARD ASP3 Filed as: TAD HOWARD | 10890 N SMITH RD HAYWARD, WI 54843 | AFLAC | $720 | — | $720 | 0.45% |
| JUSTIN H THUR3 | 4330 GOLF TER STE 206 EAU CLAIRE, WI 54703 | AFLAC | $91 | — | $91 | 0.06% |
| CHRISTOPHER P DOOLEY3 | 2903 NORTHWINDS DR EAU CLAIRE, WI 54701 | AFLAC | $63 | — | $63 | 0.04% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | AFLAC | $26 | — | $26 | 0.02% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRING PL LOUISVILLE, KY 40245 | AFLAC | $19 | — | $19 | 0.01% |
| ADAM THOMAS GARDNER3 Filed as: ADAM T GARDNER | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $17 | — | $17 | 0.01% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $15 | — | $15 | 0.01% |
| AMY KNUTSON3 | 421 HIGGINS DR EVANSVILLE, WI 53536 | AFLAC | $10 | — | $10 | 0.01% |
| WILLIAM F MURRAY III3 Filed as: WILLIAM MURRAY III | 1298 SAINT PATRICK WAY SUN PRAIRIE, WI 53590 | AFLAC | $6 | — | $6 | 0.00% |
| GREGORY M HAUGEN3 | 191 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $5 | — | $5 | 0.00% |
| MATTHEW MATARRESE3 | 203 MONTCLAIR RD IRMO, SC 29063 | AFLAC | $3 | — | $3 | 0.00% |
| JEREMY KOOI3 | 270 SHAKERAG ST MINERAL POINT, WI 53565 | AFLAC | $3 | — | $3 | 0.00% |
| NATHAN BRONSON3 | W217N5386 TAYLORS WOODS DR MENOMONEE FALLS, WI 53051 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTOPHER J ZELLNER3 | 918 ALDORA LN WAUNAKEE, WI 53597 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | VISION SERVICE PLAN | $1K | — | $1K | 4.62% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP, INC. | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55343 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $793 | $4K | 17.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | PO BOX 828 STEVENS POINT, WI 544810828 | $11K |
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 | 366 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREVEA360 HEALTH PLAN | 260 | $672K |
| Vision | VISION SERVICE PLAN | 186 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 366 | $26K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 366 | $26K |
| Other(2 contracts, 2 carriers) | AFLAC | 366 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 366 | — |
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.