| 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 | SYMETRA LIFE INSURANCE COMPANY | $0 | $10K | $10K | 1.56% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | SYMETRA LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.54% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | GUARDIAN | $18K | $2K | $20K | 15.79% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 2734 N MILDRED AVENUE #3 CHICAGO, IL 60618 | GUARDIAN | $1K | — | $1K | 0.82% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $3K | — | $3K | 5.60% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $1K | — | $1K | 9.81% |
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 | 121 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 89 | $51K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | 134 | $13K |
| Life insurance | GUARDIAN | 122 | $124K |
| Short-term disability | GUARDIAN | 122 | $124K |
| Long-term disability | GUARDIAN | 122 | $124K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 83 | $609K |
| Other | GUARDIAN | 122 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 134 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.