| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES INC. | 1477 S KNOWLES AVE #200 P O BOX 387 NEW RICHMOND, WI 54017 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $410 | $7K | 13.63% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER ASSOCIATES INC. | 1477 S KNOWLES AVE #200 P O BOX 387 NEW RICHMOND, WI 54017 | DELTA DENTAL OF WISCONSIN | $3K | — | $3K | 6.59% |
| J A COUNTER & ASSOCIATES INC3 Filed as: J A COUNTER & ASSOCIATES INC. | 1477 S KNOWLES AVE #200 P O BOX 387 NEW RICHMOND, WI 54017 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $320 | — | $320 | 4.69% |
| BENEFIT ADVISORS NETWORK LLC3 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | — | $10 | $10 | 0.15% |
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 | 143 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 58 | $43K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $50K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $50K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 143 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 143 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.