| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| T I C INC Filed as: T.I.C, INC. | 701 SAND LAKE RD ONALASKA, WI 546502442 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 4.00% |
| T I C INC | 701 SAND LAKE RD ONALASKA, WI 65676 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| NATIONAL BENEFIT CENTER | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $608 | $608 | 0.65% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| NATIONAL BENEFIT CENTER | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $525 | $525 | 0.78% |
| T I C INC3 | 701 SAND LAKE RD ONALASKA, WI 54650 | THE LINCOLN NATIONAL LIFE INSURANCE | $5K | — | $5K | 10.00% |
| NATIONAL BENEFIT CENTER | 23825 COMMERCE PARK SUITE A BEACHWOOD, OH 44122 | THE LINCOLN NATIONAL LIFE INSURANCE | — | $297 | $297 | 0.64% |
| T I C INC Filed as: T.I.C | 701 SAND LAKE ROAD ONALASKA, WI 54650 | NATIONAL VISION ADMINISTRATORS | $3K | — | $3K | 10.00% |
| TIC INC3 Filed as: TIC, INC | — | ALLSTATE | $7K | — | $7K | 22.88% |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ALLSTATE | 103 | $29K |
| Dental | DELTA DENTAL OF WISCONSIN | 366 | $248K |
| Vision | NATIONAL VISION ADMINISTRATORS | 555 | $31K |
| Life insurance(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 469 | $114K |
| Long-term disability | LINCOLN NATIONAL LIFE INSURANCE COMPANY | 469 | $93K |
| Stop-loss / reinsurancereinsurance | HCC LIFE | 200 | $390K |
| Other(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 469 | $143K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 555 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.