| 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 537132830 | TOKIO MARINE | $30K | — | $30K | 10.06% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 5.73% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537132830 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $990 | $8K | 17.13% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537132830 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $754 | $6K | 17.08% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537132810 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN | $3K | — | $3K | 10.12% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 3113 WEST BELTLINE HWY MADISON, WI 537132830 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $435 | $3K | 13.96% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TASC EIN 39-1561025 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $2K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 11 SCOTT STREET SUITE 100 WAUSAU, WI 544034808 | $2K |
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 | 485 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 490 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 174 | $96K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN | 258 | $31K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 380 | $70K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 91 | $38K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 380 | $21K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE | 212 | $302K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 380 | $70K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 380 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.