| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BENEFIT ADVISORS INSURANCE AGENCY3 | 2123 13TH ST S LA CROSSE, WI 54601 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $58K | — | $58K | 0.70% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $14K | $31K | $45K | 6.20% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $51K | — | $51K | 9.01% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $5K | $1K | $6K | 3.25% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DR MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $7K | — | $7K | 7.97% |
| BRADLEY L WALKER4 | 1216 N 3RD AVE WASHINGTON, IA 52353 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 6.00% |
| STUART W EVERSON4 | S8131 PRAIRIE RD VIROQUA, WI 54665 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 5.50% |
| WILLIAM J WALKER4 | 3215 WAYLAND RD WAYLAND, IA 52654 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | — | $1K | 5.50% |
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 | 884 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 29 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 960 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 1,802 | $8.5M |
| Dental | DELTA DENTAL OF WISCONSIN | 632 | $564K |
| Vision | WYSSTA INSURANCE COMPANY INC | 495 | $82K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 904 | $731K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 904 | $731K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 1,802 | $8.3M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 904 | $755K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,802 | — |
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."
No prospect flags tripped on this filing.