| 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 | $29K | — | $29K | 1.93% |
| M3 INSURANCE SOLUTIONS INC3 | 1610 WYNKOOP STREET SUITE 300 DENVER, CO 80202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $12K | $5K | $18K | 14.93% |
| C2 CENTRIC LLC3 | 11740 SOUTHWEST 68TH PARKWAY SUITE 2 PORTLAND, OR 97223 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $85 | — | $85 | 0.07% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $7K | — | $7K | 6.64% |
| MATTHEW A HOFELDT3 | 4918 LANTERN HOLLOW LANE WAUNAKEE, WI 53597 | AFLAC | $864 | — | $864 | 4.11% |
| GAIL ANN WISEMAN3 | 4201 WANETAH TRAIL MADISON, WI 53711 | AFLAC | $762 | — | $762 | 3.62% |
| CHRISTOPHER J ZELLNER3 | 918 ALDORA LANE WAUNAKEE, WI 53597 | AFLAC | $171 | — | $171 | 0.81% |
| ELIZABETH A LENZO3 | 1840 VIA DEL REY SOUTH PASADENA, CA 91030 | AFLAC | $146 | — | $146 | 0.69% |
| CASEY J HIGGINS3 | 2484 LEOPOLD WAY SUN PRAIRIE, WI 53590 | AFLAC | $142 | — | $142 | 0.68% |
| ROSS C NELSON3 | 4611 SOUTH 96TH STREET SUITE 100 OMAHA, NE 68127 | AFLAC | $140 | — | $140 | 0.67% |
| BRIAN D BARK3 | W5380 COUNTY ROAD CS POYNETTE, WI 53955 | AFLAC | $102 | — | $102 | 0.48% |
| AMY KNUTSON3 | 421 HIGGINS DRIVE EVANSVILLE, WI 53536 | AFLAC | $100 | — | $100 | 0.48% |
| KEVIN ZELLNER3 Filed as: KEVIN L ZELLNER | 350 COUNTY ROAD A WISCONSIN DELLS, WI 53965 | AFLAC | $73 | — | $73 | 0.35% |
| JASON SCZEPANIAK3 | 1161 HERITAGE COURT SUN PRAIRIE, WI 53590 | AFLAC | $70 | — | $70 | 0.33% |
| JEFFREY D HOEFNER3 | 3124 LORRABUD LANE SUITE 113 SUN PRAIRIE, WI 53590 | AFLAC | $51 | — | $51 | 0.24% |
| JEREMY KOOI3 | 3495 HUNTER HOLLOW ROAD DODGEVILLE, WI 53533 | AFLAC | $17 | — | $17 | 0.08% |
| ELIZABETH A LENZO3 | 11177 JASMINE DRIVE ROSCOE, IL 61073 | AFLAC | $13 | — | $13 | 0.06% |
| MARILYN L SHAW SCHUH3 | 624 EAST CRANSTON ROAD BELOIT, WI 53511 | AFLAC | $12 | — | $12 | 0.06% |
| CHRISTOPHER P DOOLEY3 | 2903 NORTHWINDS DRIVE EAU CLAIRE, WI 54701 | AFLAC | $10 | — | $10 | 0.05% |
| NATHAN BRONSON3 Filed as: NATHAN A BRONSON | W217 N5386 TAYLORS WOODS DRIVE MENOMONEE FALLS, WI 53051 | AFLAC | $10 | — | $10 | 0.05% |
| ADAM THOMAS GARDNER3 | 101 NORTH FARWELL STREET SUITE 203 EAU CLAIRE, WI 54703 | AFLAC | $8 | — | $8 | 0.04% |
| CHRISTINE LOGSLETT3 | 300 NORTH CORPORATE DRIVE SUITE 300 BROOKFIELD, WI 53045 | AFLAC | $7 | — | $7 | 0.03% |
| SHADEL & ASSOCIATES LLC3 Filed as: SHADEL & ASSOCIATES, INC. | 4811 BEACH BOULEVARD SUITE 107 JACKSONVILLE, FL 32207 | AFLAC | $1 | — | $1 | 0.00% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $955 | — | $955 | 7.80% |
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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 217 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 332 | $1.5M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 192 | $123K |
| Vision | WYSSTA INSURANCE COMPANY INC | 115 | $12K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $117K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $117K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $117K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 332 | — |
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.