| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | P.O. BOX 8950 MADISON, WI 53708 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE | $15K | $483 | $16K | 0.74% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | 150 MAIN ST, STE 300 MENASHA, WI 54952 | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE | $15K | $167 | $15K | 0.72% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | 150 MAIN ST, STE 300 MENASHA, WI 54952 | GUARDIAN | $14K | $0 | $14K | 11.22% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE, STE 300 MADISON, WI 53713 | GUARDIAN | $3K | $8K | $10K | 8.21% |
| C2 CENTRIC LLC3 | 11740 SW 68TH PARKWAY, STE 2 PORTLAND, OR 97223 | GUARDIAN | $128 | $0 | $128 | 0.10% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | P.O. BOX 8950 MADISON, WI 53708 | HUMANA INSURANCE COMPANY | $162 | $3 | $165 | 0.72% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | 150 MAIN ST, STE 300 MENASHA, WI 54952 | HUMANA INSURANCE COMPANY | $162 | $1 | $163 | 0.71% |
| MCCLONE AGENCY INC3 Filed as: MCCLONE AGENCY INC. | 150 MAIN ST, STE 300 MENASHA, WI 54952 | WYSSTA INSURANCE COMPANY INC. | $1K | $0 | $1K | 6.74% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DR MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $107 | $0 | $107 | 0.64% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLAN DRIVE, STE 30E MADISON, WI 53713 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $22 | $0 | $22 | 5.25% |
| THIRD COAST ADVISORS INC3 Filed as: THIRD COAST ADVISORS | 1166 QUAIL COURT, STE 100 PEWAUKEE, WI 53072 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1 | $0 | $1 | 0.24% |
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 | 170 | 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) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HUMANA WISCONSIN HEALTH ORGANIZATION INSURANCE | 161 | $2.1M |
| Vision | WYSSTA INSURANCE COMPANY INC. | 109 | $17K |
| Life insurance | GUARDIAN | 127 | $128K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 127 | $128K |
| Long-term disability | GUARDIAN | 127 | $128K |
| Other | GUARDIAN | 127 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.