| 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 | UNITY HEALTH PLANS INSURANCE CORPORATION | $41K | $0 | $41K | 3.28% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $1K | $4K | 11.65% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | 2209 GODWIN AVENUE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $1K | $1K | 3.00% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $740 | $3K | 18.57% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | 2209 GODWIN AVENUE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $521 | $521 | 3.00% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | WYSSTA INSURANCE COMPANY | $872 | $0 | $872 | 7.29% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $746 | $244 | $990 | 15.92% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | 2209 GODWIN AVENUE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $187 | $187 | 3.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Contract Administrator; Claims processing Service code 12 | 2801 HOOVER ROAD P.O. BOX 828 STEVENS POINT, WI 544817100 | $7K |
| M3 INSURANCE SOLUTIONS, INC. EIN 39-1141360 NONE | Insurance agents and brokers Service code 22 | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | $889 |
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 | 160 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 164 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITY HEALTH PLANS INSURANCE CORPORATION | 367 | $1.2M |
| Vision | WYSSTA INSURANCE COMPANY | 86 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $36K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $17K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 367 | $1.2M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 160 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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.