| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | GUARDIAN | $9K | $2K | $10K | 9.86% |
| JENNON CARUTH3 | 1331 HEATHER COURT CHANHASSEN, MN 55317 | GUARDIAN | $5K | — | $5K | 5.03% |
| WATCHTOWER BENEFITS, LLC3 | 2734 N MILDRED AVE #3 CHICAGO, IL 60618 | GUARDIAN | $2K | — | $2K | 1.50% |
| CARUTH, JENNON, M3 Filed as: CARUTH, JENNON M | PO BOX 46122 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $29 | $1K | 15.96% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $582 | $43 | $625 | 9.19% |
| ASSUREX GLOBAL CORPORATION3 | STE 360 6620 MOONEY ST DUBLIN, OH 43017 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $36 | $36 | 0.53% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | GUARDIAN | 107 | $104K |
| Vision | GUARDIAN | 107 | $104K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 107 | $111K |
| Short-term disability | GUARDIAN | 107 | $104K |
| Long-term disability | GUARDIAN | 107 | $104K |
| Other | GUARDIAN | 107 | $104K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.