| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $32K | — | $32K | 0.80% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $7K | 18.57% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 227 WEST MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $549 | $549 | 1.50% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $921 | $6K | 20.38% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 227 WEST MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $408 | $408 | 1.50% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $830 | $3K | 13.35% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 227 WEST MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $371 | $371 | 1.50% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $2K | — | $2K | 8.08% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $142 | $142 | 3.36% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 227 WEST MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $63 | $63 | 1.49% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $101 | $101 | 3.34% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 227 WEST MONROE ST STE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $45 | $45 | 1.49% |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 604 | $4.0M |
| Vision | WYSSTA INSURANCE COMPANY INC. | 157 | $21K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $61K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $27K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 604 | $4.0M |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 175 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 604 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.