| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS INC | 100 NORTH CORPORATE DRIVE #100 BROOKFIELD, WI 53045 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | $1K | $6K | 4.73% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | SUN LIFE ASSURANCE COMPANY OF CANADA | $422 | — | $422 | 0.33% |
| UNITED BENEFIT ADVISORS LLC3 Filed as: UNITED BENEFIT ADVISORS, INC. | 10 WUNSHINE LANE RED LION, PA 17356 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $247 | $247 | 0.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| M3 INSURANCE SOLUTIONS, INC. CLAIM PROCESSING | Claims processing Service code 12 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | $99 |
| DIVERSIFIED INSURANCE SOLUTIONS INC CLAIM PROCESSING | Claims processing Service code 12 | 100 NORTH CORPORATE DRIVE #100 BROOKFIELD, WI 53045 | $53 |
| UNITED BENEFITS ADVISORS, INC. CLAIMS PROCESSING | Claims processing Service code 12 | 10 WUNSHINE LANE RED LION, PA 17356 | $10 |
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 | 239 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 239 | $128K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 239 | $128K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 239 | $128K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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."
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.