| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTOPHER NOFFKE3 | 2920 MARKETPLACE DR. STE 103 FITCHBURG, WI 53719 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $101K | $0 | $101K | 1.76% |
| KATHRYN MUELLER3 | N19 W24075 RIVERWOOD DR. STE 210 WAUKESHA, WI 53188 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $1K | $0 | $1K | 0.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WISCONSIN MEDICAL SOCIETY HOLDINGS EIN 39-1313705 NONE | Plan Administrator Service code 14 | — | $153K |
| CLIFTONLARSONALLEN EIN 41-0746749 NONE | Other services; Accounting (including auditing) Service code 10 | — | $12K |
| TRICOR INSURANCE & FINANCIAL SVCS EIN 39-1722612 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $10K |
| GROOM LAW GROUP, CHARTERED EIN 52-1219029 NONE | Legal Service code 29 | — | $6K |
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 | 331 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 339 | Active + retired/separated + beneficiaries. No dependents. |
No Schedule A insurance contracts on this filing — typical of fully self-funded plans, where the only headcount is the Form 5500 number above.
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.