| 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 | SECURITY HEALTH PLAN OF WISCONSIN INC | $69K | — | $69K | 3.58% |
| 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 | — | $4K | 12.12% |
| PATRICIA L OBERMUELLER3 Filed as: PATRICIA OBERMUELLER | 1421 BROADWAY ST N STE 108 MENOMONIE, WI 54751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5K | — | $5K | 17.30% |
| LESLIE ROTH3 | W 6153 VALLEY PLACE HOLMEN, WI 54636 | CONTINENTAL AMERICAN INSURANCE COMPANY | $835 | — | $835 | 2.91% |
| TAD HOWARD ASP3 | 10890 N SMITH RD HAYWARD, WI 54843 | CONTINENTAL AMERICAN INSURANCE COMPANY | $619 | — | $619 | 2.16% |
| MICHAEL BECK3 | 645 8TH ST N HUDSON, WI 54016 | CONTINENTAL AMERICAN INSURANCE COMPANY | $448 | — | $448 | 1.56% |
| MICHAEL A PEDERSON3 | 101 N FARWELL ST STE 203 EAU CLAIRE, WI 54703 | CONTINENTAL AMERICAN INSURANCE COMPANY | $161 | — | $161 | 0.56% |
| CHARLOTTE HEIMER3 | 2607 50TH AVE WOODVILLE, WI 54028 | CONTINENTAL AMERICAN INSURANCE COMPANY | $87 | — | $87 | 0.30% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | VISION SERVICE PLAN | $1K | — | $1K | 4.87% |
| 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 | $12K |
| CHRISTENSEN GROUP INC AGENT | Insurance agents and brokers Service code 22 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | $1K |
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 | 471 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 471 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SECURITY HEALTH PLAN OF WISCONSIN INC | 223 | $1.9M |
| Vision | VISION SERVICE PLAN | 218 | $28K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 471 | $33K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 471 | $33K |
| Prescription drug | SECURITY HEALTH PLAN OF WISCONSIN INC | 223 | $1.9M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 471 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 471 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.