| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | 740 REGENT STREET - #400 PO BOX 259408 MADISON, WI 53725 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $49K | — | $49K | 4.79% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 53715 | DELTA DENTAL OF WISCONSIN | $8K | — | $8K | 6.92% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INC. INC | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 6.60% |
| INGENIUMPRIME INC3 Filed as: INGENIUMPRIME INC. | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $454 | — | $454 | 1.19% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INS. INC | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 10.09% |
| INGENIUMPRIME INC3 Filed as: INGENIUMPRIME INC. | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $661 | — | $661 | 1.81% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INS. INC. | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 7.60% |
| INGENIUMPRIME INC3 Filed as: INGENIUMPRIME INC. | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $365 | — | $365 | 1.56% |
| HAUSMANN GROUP INC3 Filed as: HAUSMANN GROUP | PO BOX 259408 MADISON, WI 53715 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 8.31% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE INC. | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 16.25% |
| INGENIUMPRIME INC3 Filed as: INGENIUMPRIME INC. | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $450 | — | $450 | 3.09% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 194 | $1.0M |
| Dental | DELTA DENTAL OF WISCONSIN | 168 | $117K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 120 | $15K |
| Life insurance | STANDARD INSURANCE COMPANY | 102 | $23K |
| Short-term disability | STANDARD INSURANCE COMPANY | 69 | $38K |
| Long-term disability | STANDARD INSURANCE COMPANY | 77 | $37K |
| Other(2 contracts) | STANDARD INSURANCE COMPANY | 102 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.