| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST RACINE, WI 53403 | AETNA | $28K | — | $28K | 4.00% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN STREET SUITE 320 RACINE, WI 53403 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.00% |
| MONTEREY BENEFITS LLC3 | JOHNSON INSURANCE SERVICES 8700 E PINNACLE PEAK RD SCOTTSDALE, AZ 85255 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $463 | — | $463 | 0.75% |
| WORTHAM SAN ANTONIO INC3 Filed as: JOHN DRISCOLL & COMPANY INC | 5080 N 40TH ST STE 400 PHOENIX, AZ 85018 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $58 | — | $58 | 0.09% |
| JOHNSON INSURANCE SERVICES LLC3 | 525 JUNCTION RD MADISON, WI 53717 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $317 | $4K | 14.62% |
| JOHNSON INSURANCE SERVICES LLC3 | 555 MAIN ST STE 291 RACINE, WI 53403 | UNITEDHEALTHCARE INSURANCE COMPANY | $868 | $141 | $1K | 17.34% |
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 | 110 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA | 105 | $695K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 79 | $62K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 82 | $6K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $25K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $25K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $25K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.