| 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 | $19K | $0 | $19K | 0.95% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | $13K | $0 | $13K | 0.65% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | DEAN HEALTH PLAN INC. | $12K | $0 | $12K | 2.68% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | DELTA DENTAL OF WISCONSIN | $11K | $0 | $11K | 6.37% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | HARTFORD LIFE AND ACCIDENT | $8K | $0 | $8K | 5.02% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | PO BOX 3430 CARMEL, IN 46082 | HARTFORD LIFE AND ACCIDENT | $4K | $0 | $4K | 2.46% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $1K | $0 | $1K | 4.74% |
| MJ INSURANCE3 Filed as: MJ INSURANCE INC. | 571 MONON BOULEVARD SUITE 400 CARMEL, IN 46032 | WYSSTA INSURANCE COMPANY INC. | $857 | $0 | $857 | 3.70% |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 294 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WISCONSIN | 430 | $2.4M |
| Dental | DELTA DENTAL OF WISCONSIN | 281 | $177K |
| Vision | WYSSTA INSURANCE COMPANY INC. | 170 | $23K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 306 | $153K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 306 | $153K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 306 | $153K |
| Other | HARTFORD LIFE AND ACCIDENT | 306 | $153K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 430 | — |
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.