| 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 | $250K | $1K | $252K | 3.01% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 100 NORTH CORPORATE DRIVE STE 100 BROOKFIELD, WI 53045 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | $0 | $4K | $4K | 0.04% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $45K | — | $45K | 10.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.72% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC-WI | 711 EISENHOWER DR KIMBERLY, WI 54136 | DELTA DENTAL OF WISCONSIN | $14K | — | $14K | 3.28% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | HUMANA INSURANCE COMPANY | $3K | — | $3K | 3.87% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | HUMANA INSURANCE COMPANY | $0 | $715 | $715 | 0.85% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | — | $8K | 10.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $549 | $549 | 0.72% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $13K | — | $13K | 20.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $471 | $471 | 0.72% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $362 | $362 | 0.72% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $888 | $8K | 22.35% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $444 | $444 | 1.17% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $782 | $7K | 22.52% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $391 | $391 | 1.26% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 20.00% |
| BENEFIT ADVISORS NETWORK LLC3 | 6830 COCHRAN RD SOLON, OH 44139 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $64 | $64 | 0.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HY HOLDINGS DBA HEALTHIEST YOU EIN 30-0947669 PLAN ADMINISTRATOR | Plan Administrator Service code 14 | — | $61K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $13K |
| USI INSURANCE BROKER | Insurance agents and brokers Service code 22 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | $9K |
| USI INSURANCE SERVICES, LLC BROKER | Insurance agents and brokers Service code 22 | 711 EISENHOWER DR. KIMBERLY, WI 54136 | $612 |
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 | 482 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 17 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 506 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | 436 | $8.4M |
| Dental | DELTA DENTAL OF WISCONSIN | 431 | $425K |
| Vision | HUMANA INSURANCE COMPANY | 341 | $84K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 371 | $115K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 403 | $448K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 403 | $76K |
| Other(7 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE CORPORAT | 617 | $8.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 617 | — |
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.