| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | BLUE CROSS BLUE SHIELD OF WISCONSIN | $33K | — | $33K | 2.81% |
| PAUL CELLA Filed as: PAUL J CELLA | KEYARX CAPITAL ADVISORS 102 CRAWFORDS CORNER ROAD STE. 1300 HOLMDEL, NJ 07733 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | — | $6K | 6.06% |
| KEYARX CAPITAL ADVISORS | 101 CRAWFORDS CORNER ROAD SUITE 1300 HOLMDEL, NJ 07733 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 4.97% |
| MGIS | 111 SOUTH MAIN STREET STE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $180 | $180 | 0.18% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $10K | — | $10K | 10.86% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $950 | — | $950 | 8.61% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC. | $850 | — | $850 | 7.70% |
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 | 199 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 397 | $1.2M |
| Dental | DELTA DENTAL OF WISCONSIN | 128 | $92K |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF WISCONSIN | 397 | $1.2M |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 127 | $101K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 127 | $101K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 127 | $101K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 127 | $101K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
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.