| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53713 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $0 | $5K | $5K | 6.17% |
| C2 CENTRIC LLC3 | 11740 SW 68TH PARKWAY SUITE 2 PORTLAND, OR 97223 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $90 | — | $90 | 0.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AUXIANT CLAIMS PROCESSING | Claims processing; Insurance agents and brokers Service code 12 | 2450 RIMROCK RD MADISON, WI 53713 | $80K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $6K |
| M3 INSURANCE SOLUTIONS INC INSURANCE AGENT OR BROKE | Insurance agents and brokers Service code 22 | 828 JOHN NOLEN DR MADISON, WI 53713 | $63 |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $80K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $80K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $80K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE INSURANCE CO | 136 | $242K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 194 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.