| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SERVICES INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $25K | — | $25K | 0.94% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY SUITE 1950 ATLANTA, GA 30339 | CAREFIRST BLUECHOICE, INC. | — | $41K | $41K | 3.45% |
| AMWINS5 Filed as: AMWINS CONNECT ADMINISTRATORS, INC | 6 NORTH PARK DRIVE S 310 HUNT VALLEY, MD 21030 | CAREFIRST BLUECHOICE, INC. | — | $6K | $6K | 0.54% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $3K | $12K | 5.81% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 WEST ERIE ST SUITE #300 CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 1.50% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | VISION SERVICE PLAN | $3K | — | $3K | 5.01% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 WEST ERIE ST STE #300 CHICAGO, IL 60654 | VISION SERVICE PLAN | $197 | — | $197 | 0.38% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $735 | $8K | 16.48% |
| WATCHTOWER TECHNOLOGIES INC3 | 306 WEST ERIE ST SUITE #300 CHICAGO, IL 60654 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $744 | — | $744 | 1.50% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | FEDERAL INSURANCE COMPANY | $1K | — | $1K | 14.99% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | FIRST UNUM LIFE INSURANCE COMPANY | $171 | $18 | $189 | 16.59% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA (DENTAL BENEFIT) | Contract Administrator Service code 13 | — | $14K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Contract Administrator; Claims processing Service code 12 | — | $5K |
| M3 INSURANCE SOLUTIONS INC INS AGENT OR BROKER | Insurance agents and brokers Service code 22 | 828 JOHN NOLEN DR MADISON, WI 53713 | $1K |
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 70 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 323 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 346 | $3.8M |
| Vision | VISION SERVICE PLAN | 247 | $52K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 252 | $260K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 252 | $210K |
| Prescription drug(2 contracts, 2 carriers) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 346 | $3.8M |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 319 | $272K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 346 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.