| 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 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $37K | — | $37K | 2.48% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | COMPCARE HEALTH SERVICES INSURANCE CORPORATION | $12K | — | $12K | 2.99% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $7K | — | $7K | 8.74% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $3K | $2K | $5K | 8.41% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | $0 | $2K | $2K | 4.00% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $124 | $124 | 0.22% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $4K | $1K | $5K | 13.95% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 4.00% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $76 | $76 | 0.23% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $4K | $754 | $5K | 22.76% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | — | $905 | $905 | 4.00% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | $56 | — | $56 | 0.25% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | STANDARD INSURANCE COMPANY | $2K | $663 | $2K | 11.92% |
| PAYCOM PAYROLL LLC3 Filed as: PAYCOM PAYROLL HOLDINGS LLC | 7501 W MEMORIAL RD OKLAHOMA CITY, OK 73142 | STANDARD INSURANCE COMPANY | $0 | $786 | $786 | 4.00% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | — | $50 | $50 | 0.25% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 8.00% |
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 | 223 | 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) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 174 | $1.9M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 174 | $1.6M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 174 | $1.5M |
| Life insurance | STANDARD INSURANCE COMPANY | 314 | $57K |
| Short-term disability | STANDARD INSURANCE COMPANY | 63 | $20K |
| Long-term disability | STANDARD INSURANCE COMPANY | 223 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 314 | — |
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."
No prospect flags tripped on this filing.