| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DR. MADISON, WI 53713 | UNITY HEALTH PLANS INSURANCE CORPORATION | $17K | — | $17K | 1.28% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $9K | — | $9K | 1.79% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $10K | — | $10K | 1.91% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $10K | — | $10K | 2.23% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 3113 WEST BELTLINE HIGHWAY MADISON, WI 53708 | GUNDERSEN HEALTH PLAN, INC. | $4K | — | $4K | 2.24% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | PO BOX 8950 MADISON, WI 537088950 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $4K | $13K | 15.10% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | PO BOX 8950 MADISON, WI 537088950 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 15.10% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | PO BOX 8950 MADISON, WI 537088950 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 17.62% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | PO BOX 8950 MADISON, WI 537088950 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $874 | $5K | 17.75% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DR MADISON, WI 537130000 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 7.37% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537130000 | WYSSTA INSURANCE COMPANY INC | $337 | — | $337 | 8.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Contract Administrator Service code 13 | — | $14K |
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 | 463 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 466 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | UNITY HEALTH PLANS INSURANCE CORPORATION | 245 | $3.0M |
| Vision(2 contracts) | WYSSTA INSURANCE COMPANY INC. | 111 | $20K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 459 | $119K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 120 | $55K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 245 | $1.3M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 459 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 459 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.