| 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 | $25K | — | $25K | 1.17% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $15K | — | $15K | 2.11% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $4K | $2K | $5K | 6.10% |
| THE ULTIMATE SOFTWARE GROUP3 | ATTN CLIENT ONE1020 PO BOX 930953 ATLANTA, GA 31193 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 1.12% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $556 | $556 | 0.62% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $3K | $1K | $5K | 7.15% |
| THE ULTIMATE SOFTWARE GROUP3 | ATTN CLIENT ONE1020 PO BOX 930953 ATLANTA, GA 31193 | STANDARD INSURANCE COMPANY | — | $740 | $740 | 1.13% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $460 | $460 | 0.70% |
| M3 INS SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $4K | $900 | $5K | 11.24% |
| THE ULTIMATE SOFTWARE GROUP3 | ATTN CLIENT ONE1020 PO BOX 930953 ATLANTA, GA 31193 | STANDARD INSURANCE COMPANY | — | $536 | $536 | 1.16% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $299 | $299 | 0.65% |
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 | 240 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | 117 | $716K |
| Life insurance | STANDARD INSURANCE COMPANY | 242 | $66K |
| Short-term disability | STANDARD INSURANCE COMPANY | 154 | $89K |
| Long-term disability | STANDARD INSURANCE COMPANY | 221 | $46K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 392 | $2.1M |
| Other | STANDARD INSURANCE COMPANY | 242 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 392 | — |
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.