| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DR. MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $19K | — | $19K | 1.14% |
| M3 INSURANCE SOLUTIONS INC3 | 3113 W BELTLINE HWY MADISON, WI 53708 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $28K | — | $28K | 2.26% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON OPTIONS, INC. | $12K | — | $12K | 1.75% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $12K | — | $12K | 1.79% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $7K | $16K | 16.26% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $3K | $7K | 15.57% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 14.74% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 17.80% |
| M3 INSURANCE SOLUTIONS INC3 | PO BOX 8950 MADISON, WI 53708 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 16.35% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DR MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 8.03% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $873 | — | $873 | 7.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Contract Administrator Service code 13 | — | $18K |
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 | 452 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 453 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 262 | $4.2M |
| Vision(2 contracts) | WYSSTA INSURANCE COMPANY INC. | 121 | $27K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 455 | $137K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 63 | $18K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 121 | $73K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 262 | $1.7M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 455 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 455 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.