| 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 | $33K | — | $33K | 1.93% |
| M3 INSURANCE SOLUTIONS INC3 | 1610 WYNKOOP STREET SUITE 300 DENVER, CO 80202 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $15K | $6K | $21K | 13.60% |
| C2 CENTRIC LLC3 | 11740 SOUTHWEST 68TH PARKWAY SUITE 2 PORTLAND, OR 97223 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $115 | — | $115 | 0.08% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $9K | — | $9K | 6.51% |
| MATTHEW A HOFELDT3 | 4918 LANTERN HOLLOW LANE WAUNAKEE, WI 53597 | AFLAC | $1K | $79 | $1K | 6.20% |
| GAIL ANN WISEMAN3 | 4201 WANETAH TRAIL MADISON, WI 53711 | AFLAC | $543 | — | $543 | 2.64% |
| CHRISTOPHER J ZELLNER3 | 918 ALDORA LANE WAUNAKEE, WI 53597 | AFLAC | $264 | $16 | $280 | 1.36% |
| CASEY J HIGGINS3 Filed as: CASEY HIGGINS | 3083 LYMANS RUN SUN PRAIRIE, WI 53590 | AFLAC | $223 | $18 | $241 | 1.17% |
| ELIZABETH A LENZO3 | 701 ALBEROSKY WAY BATAVIA, IL 60510 | AFLAC | $159 | — | $159 | 0.77% |
| ROSS C NELSON3 Filed as: ROSS NELSON | 440 REGENCY PARKWAY DRIVE SUITE 234 OMAHA, NE 68114 | AFLAC | $131 | — | $131 | 0.64% |
| BRIAN D BARK3 | W5380 COUNTY ROAD CS POYNETTE, WI 53955 | AFLAC | $98 | — | $98 | 0.48% |
| REBECCA A BAERTSCHI3 Filed as: REBECCA BERTSCHI | 209 WEST MAIN STREET BROOKLYN, WI 53521 | AFLAC | $68 | $13 | $81 | 0.39% |
| KEVIN ZELLNER3 | 350 COUNTY ROAD A WISCONSIN DELLS, WI 53965 | AFLAC | $73 | — | $73 | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: JASON GALLAGHER | 5578 AUCHTER LANE WAUNAKEE, WI 53597 | AFLAC | $71 | — | $71 | 0.35% |
| JASON SCZEPANIAK3 | 1161 HERITAGE COURT SUN PRAIRIE, WI 53590 | AFLAC | $51 | — | $51 | 0.25% |
| AMY KNUTSON3 | 421 HIGGINS DRIVE EVANSVILLE, WI 53536 | AFLAC | $49 | — | $49 | 0.24% |
| JEFFREY D HOEFNER3 Filed as: JEFFREY HOEFNER | 3124 LORRABUD LANE SUN PRAIRIE, WI 53590 | AFLAC | $46 | — | $46 | 0.22% |
| MICHAEL FRASIER3 | 4001 FELLAND ROAD SUITE 113 MADISON, WI 53718 | AFLAC | $34 | $3 | $37 | 0.18% |
| JEREMY KOOI3 | 3495 HUNTER HOLLOW ROAD DODGEVILLE, WI 53533 | AFLAC | $12 | — | $12 | 0.06% |
| CHRISTOPHER P DOOLEY3 Filed as: CHRISTOPHER DOOLEY | 2903 NORTHWINDS DRIVE EAU CLAIRE, WI 54701 | AFLAC | $10 | — | $10 | 0.05% |
| NATHAN BRONSON3 | W2177N5386 TAYLORS WOODS DRIVE MENOMONEE FALLS, WI 53051 | AFLAC | $10 | — | $10 | 0.05% |
| ADAM THOMAS GARDNER3 Filed as: ADAM GARDNER | 101 NORTH FARWELL STREET SUITE 203 EAU CLAIRE, WI 54703 | AFLAC | $7 | — | $7 | 0.03% |
| CHRISTINE LOGSLETT3 | 300 NORTH CORPORATE DRIVE SUITE 300 BROOKFIELD, WI 53045 | AFLAC | $7 | — | $7 | 0.03% |
| MARILYN L SHAW SCHUH3 | 624 EAST CRANSTON ROAD BELOIT, WI 53511 | AFLAC | $2 | — | $2 | 0.01% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE INSURANCE COMPANY INC | $902 | — | $902 | 8.76% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $561 | — | $561 | 7.92% |
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 | 223 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 228 | $1.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF WISCONSIN | 236 | $156K |
| Vision(2 contracts, 2 carriers) | WYSSTA INSURANCE INSURANCE COMPANY INC | 85 | $17K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $153K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $153K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $153K |
| Other(2 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 262 | $173K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 262 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.