| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $27K | — | $27K | 2.74% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $3K | $9K | 15.69% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $637 | $3K | 21.57% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM INSURANCE COMPANY | $2K | $555 | $2K | 21.80% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $1K | — | $1K | 11.80% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $778 | — | $778 | 8.34% |
| JENNON M CARUTH3 | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $244 | $4K | 54.23% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $754 | $90 | $844 | 11.19% |
| JENNON M CARUTH3 | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $201 | $2K | 39.23% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $498 | $73 | $571 | 9.19% |
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 | 156 | 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) | 156 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 215 | $991K |
| Dental | DELTA DENTAL OF WISCONSIN | 171 | $10K |
| Vision | WYSSTA INSURANCE COMPANY INC | 82 | $9K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 156 | $80K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 156 | $59K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 156 | $59K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 215 | $991K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 156 | $97K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 215 | — |
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.