| 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 537131424 | QBE INSURANCE CORPORATION | $28K | $0 | $28K | 9.14% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | STANDARD INSURANCE COMPANY | $7K | $0 | $7K | 10.49% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | P.O. BOX 6824 GRAND RAPIDS, MI 49516 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 2.50% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | CARE-PLUS DENTAL PLANS, INC. | $941 | $0 | $941 | 6.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 NONE | Contract Administrator; Claims processing Service code 12 | 11 SCOTT STREET SE SUITE 100 WAUSAU, WI 544034808 | $82K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Claims processing; Contract Administrator Service code 12 | 2801 HOOVER ROAD P.O. BOX 828 STEVENS POINT, WI 544817100 | $5K |
| M3 INSURANCE SOLUTIONS, INC. EIN 39-1141360 NONE | Insurance agents and brokers Service code 22 | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | $651 |
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 | 185 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CARE-PLUS DENTAL PLANS, INC. | 75 | $16K |
| Life insurance | STANDARD INSURANCE COMPANY | 187 | $70K |
| Short-term disability | STANDARD INSURANCE COMPANY | 187 | $70K |
| Long-term disability | STANDARD INSURANCE COMPANY | 187 | $70K |
| Stop-loss / reinsurancereinsurance | QBE INSURANCE CORPORATION | 124 | $310K |
| Other | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | 124 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.