| 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 | $49K | — | $49K | 9.76% |
| PATRICIA L OBERMUELLER3 Filed as: PATRICIA OBERMUELLER | 1421 BROADWAY ST N STE 108 MENOMONIE, WI 54751 | AFLAC | $13K | $385 | $14K | 32.48% |
| MICHAEL BECK3 | 645 8TH ST N HUDSON, WI 54016 | AFLAC | $5K | $91 | $5K | 12.69% |
| TAD HOWARD ASP3 Filed as: TAD ASP | 10890 N SMITH RD HAYWARD, WI 54843 | AFLAC | $1K | $91 | $2K | 3.53% |
| MICHAEL A PEDERSON3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $1K | — | $1K | 3.38% |
| SHELLY VANYO INVESTMENTS INC3 Filed as: SHELLY VANYO INVESTMENT, INC. | N6926 495TH ST MENOMONIE, WI 54751 | AFLAC | $1K | — | $1K | 2.75% |
| CHARLOTTE HEIMER3 | 2607 50TH AVE WOODVILLE, WI 54028 | AFLAC | $794 | — | $794 | 1.86% |
| JUSTIN H THUR3 | 4330 GOLF TER STE 206 EAU CLAIRE, WI 54703 | AFLAC | $68 | — | $68 | 0.16% |
| CHRISTOPHER P DOOLEY3 | 2903 NORTHWINDS DR EAU CLAIRE, WI 54701 | AFLAC | $61 | — | $61 | 0.14% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | AFLAC | $28 | — | $28 | 0.07% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRING PL LOUISVILLE, KY 40245 | AFLAC | $21 | — | $21 | 0.05% |
| ADAM THOMAS GARDNER3 Filed as: ADAM T GARDNER | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $19 | — | $19 | 0.04% |
| JASON SCZEPANIAK3 | 1161 HERITAGE CT SUN PRAIRIE, WI 53590 | AFLAC | $14 | — | $14 | 0.03% |
| JEANETTE ROED3 | PO BOX 806 ELLSWORTH, WI 54011 | AFLAC | $12 | — | $12 | 0.03% |
| AMY KNUTSON3 | 421 HIGGINS DR EVANSVILLE, WI 53536 | AFLAC | $11 | — | $11 | 0.03% |
| BRIANNA BUCHOLZ3 | W3786 650TH AVE SPRING VALLEY, WI 54767 | AFLAC | $10 | — | $10 | 0.02% |
| GREGORY M HAUGEN3 | 191 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | AFLAC | $6 | — | $6 | 0.01% |
| WILLIAM F MURRAY III3 Filed as: WILLIAM MURRAY III | 1298 SAINT PATRICK WAY SUN PRAIRIE, WI 53590 | AFLAC | $6 | — | $6 | 0.01% |
| JEREMY KOOI3 | 270 SHAKERAG ST MINERAL POINT, WI 53565 | AFLAC | $3 | — | $3 | 0.01% |
| MATTHEW MATARRESE3 | 203 MONTCLAIR RD IRMO, SC 29063 | AFLAC | $3 | — | $3 | 0.01% |
| NATHAN BRONSON3 | W217N5386 TAYLORS WOODS DR MENOMONEE FALLS, WI 53051 | AFLAC | $2 | — | $2 | 0.00% |
| CHRISTOPHER J ZELLNER3 | 918 ALDORA LN WAUNAKEE, WI 53597 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP, INC. | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55343 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 12.95% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | VISION SERVICE PLAN | $1K | — | $1K | 5.47% |
| 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 | 369 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 380 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREVEA360 HEALTH PLAN | 224 | $504K |
| Vision | VISION SERVICE PLAN | 175 | $24K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 369 | $25K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 369 | $25K |
| Other(2 contracts, 2 carriers) | AFLAC | 369 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 369 | — |
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.