| 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 | DEAN HEALTH PLAN | $18K | — | $18K | 1.01% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $6K | — | $6K | 4.44% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $5K | — | $5K | 7.91% |
| THE RICHARDS GROUP3 Filed as: RICHARDS AGENCY | PO BOX 277 BEAVER DAM, WI 53916 | HARTFORD LIFE AND ACCIDENT | $2K | — | $2K | 2.32% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 6.49% |
| RICHARDS BENEFITS & FINANCIAL3 Filed as: RICHARDS BENEFITS AND FINANCIAL | PO BOX 277 BEAVER DAM, WI 53916 | WYSSTA INSURANCE COMPANY INC. | $223 | — | $223 | 1.39% |
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 | 136 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 136 | $135K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 188 | $68K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 188 | $68K |
| Stop-loss / reinsurancereinsurance | HARTFORD LIFE AND ACCIDENT | 188 | $68K |
| Other | HARTFORD LIFE AND ACCIDENT | 188 | $68K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 267 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.