| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OLSON, AMY3 | M3 INSURANCE SOLUTIONS INC 828 JOHN NOLEN DRIVE MADISON, WI 53713 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $60K | — | $60K | 1.93% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $8K | — | $8K | 3.81% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.05% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.76% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DR MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $2K | — | $2K | 8.11% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 5.00% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $814 | — | $814 | 15.00% |
| DEANNA M GILLETT3 | 205 WEST COURT STREET ELKHORN, WI 53121 | AFLAC | $231 | — | $231 | 6.41% |
| MICHAEL E MILLARD3 | W3648 SCOTCH BUSH ROAD ELKHORN, WI 53121 | AFLAC | $59 | — | $59 | 1.64% |
| REBECCA A BAERTSCHI3 | 209 W MAIN STREET BROOKLYN, WI 53521 | AFLAC | $30 | — | $30 | 0.83% |
| RONALD E EICHSTAEDT3 | 75 NORTH OAK STREET APARTMENT 205 PLATTEVILLE, WI 53818 | AFLAC | $24 | — | $24 | 0.67% |
| GAIL ANN WISEMAN3 | 4201 WANETAH TRAIL MADISON, WI 53711 | AFLAC | $18 | — | $18 | 0.50% |
| BRAD M PINCHART3 | 6696 PRAIRIE CREEK RD WINDSOR, WI 53598 | AFLAC | $15 | — | $15 | 0.42% |
| AMY KNUTSON3 | 421 HIGGINS DRIVE EVANSVILLE, WI 53536 | AFLAC | $14 | — | $14 | 0.39% |
| CASEY J HIGGINS3 | 2484 LEOPOLD WAY SUN PRAIRIE, WI 53590 | AFLAC | $13 | — | $13 | 0.36% |
| ROSS C NELSON3 | 4001 FELLAND ROAD SUITE 106 MADISON, WI 53718 | AFLAC | $11 | — | $11 | 0.31% |
| JASON SCZEPANIAK3 | 4001 FELLAND ROAD SUITE 106 MADISON, WI 53718 | AFLAC | $11 | — | $11 | 0.31% |
| MICHAEL FRASIER3 | 374 BELLA WAY SUN PRAIRIE, WI 53590 | AFLAC | $11 | — | $11 | 0.31% |
| ELIZABETH A LENZO3 | 1949 S EUCLID AVE SAN MARINO, CA 91108 | AFLAC | $8 | — | $8 | 0.22% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRINGS PLACE LOUISVILLE, KY 40245 | AFLAC | $8 | — | $8 | 0.22% |
| MICHAEL FRASIER3 | 2996 WAUBESA AVENUE MADISON, WI 53711 | AFLAC | $6 | — | $6 | 0.17% |
| CHRIS ZELLNER3 | 4001 FELLAND ROAD SUITE 106 MADISON, WI 53718 | AFLAC | $5 | — | $5 | 0.14% |
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 | 324 | 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) | 326 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 282 | $3.1M |
| Dental | DELTA DENTAL OF WISCONSIN | 280 | $222K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 136 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $35K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 93 | $24K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $32K |
| Other(4 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 324 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 324 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.