| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | $165K | $2K | $166K | 3.02% |
| SCOTT, JAY N3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | $1 | — | $1 | 0.00% |
| ASSOCIATED BENEFITS & RISK CON3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | DELTA DENTAL OF WISCONSIN | $8K | — | $8K | 3.07% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $22K | — | $22K | 10.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 5.91% |
| SCOTT, JAY N3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | -$3 | — | -$3 | -0.01% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | — | $6K | 20.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $644 | — | $644 | 20.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HY HOLDINGS DBA HEALTHIEST YOU EIN 30-0947669 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $13K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $7K |
| HEATHER WARE NELSON BROKER | Insurance agents and brokers Service code 22 | 51482 WEST WYMER LAKE ROAD FRAZEE, MN 56501 | $2K |
| ASSOCIATED BENEFITS AND RISK CONSUL BROKER | Insurance agents and brokers Service code 22 | 711 EISENHOWER DR. KIMBERLY, WI 54136 | $343 |
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 | 301 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 4 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 307 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | 270 | $5.5M |
| Dental | DELTA DENTAL OF WISCONSIN | 266 | $267K |
| Vision | HUMANA INSURANCE COMPANY | 200 | $44K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 267 | $53K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 267 | $224K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 0 | $36K |
| Other(3 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 322 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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.