| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER NOFFKE3 | 2920 MARKETPLACE DR. STE 103 FITCHBURG, WI 53719 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $91K | $0 | $91K | 1.62% |
| KATHRYN MUELLER3 | N19 W24075 RIVERWOOD DR. STE 210 WAUKESHA, WI 53188 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $2K | $0 | $2K | 0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WISCONSIN MEDICAL SOCIETY HOLDINGS EIN 39-1313705 NONE | Plan Administrator Service code 14 | — | $50K |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE | Legal Service code 29 | — | $23K |
| CLIFTONLARSONALLEN EIN 41-0746749 NONE | Accounting (including auditing); Other services Service code 10 | — | $12K |
| TRICOR INSURANCE & FINANCIAL SVCS EIN 39-1722612 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $10K |
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 | 340 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 344 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | 928 | $5.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 928 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.