| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $18K | — | $18K | 0.67% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INSURANCE INC | 700 REGENT STREET #400 MADISON, WI 53715 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $9K | — | $9K | 0.35% |
| M3 INS SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $6K | $3K | $9K | 9.91% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INS INC | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $529 | — | $529 | 0.57% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $251 | $251 | 0.27% |
| M3 INS SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $4K | $2K | $6K | 11.21% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INS INC | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $527 | — | $527 | 0.98% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $126 | $126 | 0.23% |
| M3 INS SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $7K | $1K | $8K | 17.43% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INS INC | PO BOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $525 | — | $525 | 1.14% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $101 | $101 | 0.22% |
| M3 INS SOLUTIONS INC3 Filed as: M3 INS SOULTIONS INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $7K | $2K | $9K | 25.37% |
| WATCHTOWER TECHNOLOGIES INC3 | 227 WEST MONROE STREET SUITE 5200 CHICAGO, IL 60606 | STANDARD INSURANCE COMPANY | — | $138 | $138 | 0.37% |
| HAUSMANN-JOHNSON INSURANCE INC3 Filed as: HAUSMANN JOHNSON INS INC | PO BNOX 259408 MADISON, WI 53725 | STANDARD INSURANCE COMPANY | $24 | — | $24 | 0.07% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 7.34% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 474 | $2.7M |
| Vision | WYSSTA INSURANCE COMPANY INC | 139 | $22K |
| Life insurance | STANDARD INSURANCE COMPANY | 234 | $92K |
| Short-term disability | STANDARD INSURANCE COMPANY | 102 | $54K |
| Long-term disability | STANDARD INSURANCE COMPANY | 234 | $46K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 474 | $2.7M |
| Other(3 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 250 | $135K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 474 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.