| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE AMY OLSON MADISON, WI 53713 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $24K | — | $24K | 1.93% |
| M3 INSURANCE SOLUTIONS INC3 | 1610 WYNKOOP STREET SUITE 300 DENVER, CO 80202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 10.41% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $5K | — | $5K | 6.59% |
| MATTHEW A HOFELDT3 | 4918 LANTERN HOLLOW LANE WAUNAKEE, WI 53597 | AFLAC | $885 | — | $885 | 4.40% |
| GAIL ANN WISEMAN3 | 4201 WANETAH TRAIL MADISON, WI 53711 | AFLAC | $725 | — | $725 | 3.60% |
| CASEY J HIGGINS3 | 2484 LEOPOLD WAY SUN PRAIRIE, WI 53590 | AFLAC | $138 | — | $138 | 0.69% |
| CHRIS ZELLNER3 | 918 ALDORA LANE WAUNAKEE, WI 53597 | AFLAC | $126 | — | $126 | 0.63% |
| ROSS C NELSON3 | 4611 SOUTH 96TH STREET SUITE 100 OMAHA, NE 68127 | AFLAC | $108 | — | $108 | 0.54% |
| BRIAN D BARK3 | W5380 COUNTY ROAD CS POYNETTE, WI 53955 | AFLAC | $97 | — | $97 | 0.48% |
| AMY KNUTSON3 | 421 HIGGINS DRIVE EVANSVILLE, WI 53536 | AFLAC | $92 | — | $92 | 0.46% |
| JEFFREY D HOEFNER3 | 4001 FELLAND ROAD SUITE 113 MADISON, WI 53718 | AFLAC | $90 | — | $90 | 0.45% |
| ELIZABETH A LENZO3 | 11177 JASMINE DRIVE ROSCOE, IL 61073 | AFLAC | $87 | — | $87 | 0.43% |
| ELIZABETH A LENZO3 | 265 WEST NAOMI AVENUE ARCADIA, CA 91007 | AFLAC | $71 | — | $71 | 0.35% |
| JASON SCZEPANIAK3 | 1161 HERITAGE COURT SUN PRAIRIE, WI 53590 | AFLAC | $66 | — | $66 | 0.33% |
| KEVIN ZELLNER3 Filed as: KEVIN L ZELLNER | 350 COUNTY ROAD A WISCONSIN DELLS, WI 53965 | AFLAC | $43 | — | $43 | 0.21% |
| KEVIN ZELLNER3 Filed as: KEVIN L ZELLNER | 125 EAST HOLUM STREET APARTMENT 208 DEFOREST, WI 53532 | AFLAC | $24 | — | $24 | 0.12% |
| ROSS C NELSON3 | 4001 FELLAND ROAD SUITE 106 MADISON, WI 53718 | AFLAC | $23 | — | $23 | 0.11% |
| MARILYN L SHAW SCHUH3 | 624 EAST CRANSTON ROAD BELOIT, WI 53511 | AFLAC | $11 | — | $11 | 0.05% |
| JEREMY KOOI3 | 3495 HUNTER HOLLOW ROAD DODGEVILLE, WI 53533 | AFLAC | $3 | — | $3 | 0.01% |
| CHRISTOPHER P DOOLEY3 | 2903 NORTHWINDS DRIVE EAU CLAIRE, WI 54701 | AFLAC | $1 | — | $1 | 0.00% |
| NATHAN BRONSON3 Filed as: NATHAN A BRONSON | W217 N5386 TAYLORS WOODS DRIVE MENOMONEE FALLS, WI 53051 | AFLAC | $1 | — | $1 | 0.00% |
| ADAM THOMAS GARDNER3 | 101 NORTH FARWELL STREET SUITE 203 EAU CLAIRE, WI 54703 | AFLAC | $1 | — | $1 | 0.00% |
| CHRISTINE LOGSLETT3 | 300 NORTH CORPORATE DRIVE SUITE 300 BROOKFIELD, WI 53045 | AFLAC | $1 | — | $1 | 0.00% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $861 | — | $861 | 8.10% |
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 | 154 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 156 | $1.3M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 156 | $102K |
| Vision | WYSSTA INSURANCE COMPANY INC | 89 | $11K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $86K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $86K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $86K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 188 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 188 | — |
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.