| 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 53713 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $18K | — | $18K | 1.93% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 6.43% |
| M3 INSURANCE SOLUTIONS INC3 | 1610 WYNKOOP STREET SUITE 300 DENVER, CO 80202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $3K | $10K | 16.32% |
| MATTHEW A HOFELDT3 | 4918 LANTERN HOLLOW LANE WAUNAKEE, WI 53597 | AFLAC | $2K | $77 | $2K | 7.98% |
| GAIL ANN WISEMAN3 | 4201 WANETAH TRAIL MADISON, WI 53711 | AFLAC | $974 | $26 | $1K | 4.73% |
| CASEY J HIGGINS3 | 2484 LEOPOLD WAY SUN PRAIRIE, WI 53590 | AFLAC | $234 | $21 | $255 | 1.21% |
| ELIZABETH A LENZO3 | 265 WEST NAOMI AVENUE ARCADIA, CA 91007 | AFLAC | $170 | — | $170 | 0.80% |
| ROSS C NELSON3 | 4611 SOUTH 96TH STREET SUITE 100 OMAHA, NE 68127 | AFLAC | $160 | $5 | $165 | 0.78% |
| JEFFREY D HOEFNER3 | 4001 FELLAND ROAD SUITE 113 MADISON, WI 53718 | AFLAC | $145 | $11 | $156 | 0.74% |
| CHRIS ZELLNER3 | 918 ALDORA LANE WAUNAKEE, WI 53597 | AFLAC | $130 | — | $130 | 0.62% |
| BRIAN D BARK3 | W5380 COUNTY ROAD CS POYNETTE, WI 53955 | AFLAC | $120 | — | $120 | 0.57% |
| AMY KNUTSON3 | 421 HIGGINS DRIVE EVANSVILLE, WI 53536 | AFLAC | $100 | — | $100 | 0.47% |
| JASON SCZEPANIAK3 | 4001 FELLAND ROAD SUITE 106 MADISON, WI 53718 | AFLAC | $80 | $6 | $86 | 0.41% |
| KEVIN ZELLNER3 Filed as: KEVIN L ZELLNER | 125 EAST HOLUM STREET APARTMENT 208 DEFOREST, WI 53532 | AFLAC | $74 | — | $74 | 0.35% |
| MARILYN L SHAW SCHUH3 | 624 CRANSTON ROAD BELOIT, WI 53511 | AFLAC | $19 | $4 | $23 | 0.11% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $711 | — | $711 | 8.20% |
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 | 153 | 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) | 153 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 128 | $952K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 130 | $89K |
| Vision | WYSSTA INSURANCE COMPANY INC | 80 | $9K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 153 | $61K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 153 | $61K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 153 | $61K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 153 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.