| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $27K | — | $27K | 3.02% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 14.62% |
| WATCH TOWER TECHNOLOGIES INC3 Filed as: WATCH TOWER TECH. | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $238 | $238 | 1.05% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 15.65% |
| WATCH TOWER TECHNOLOGIES INC3 Filed as: WATCH TOWER TECH. | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $212 | $212 | 1.05% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 19.69% |
| WATCH TOWER TECHNOLOGIES INC3 Filed as: WATCH TOWER TECH. | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $171 | $171 | 1.05% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC. | $1K | — | $1K | 8.72% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | UNUM INSURANCE COMPANY | $2K | $251 | $2K | 20.43% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOH NOLEN DR MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY | $287 | — | $287 | 8.01% |
| JENNON M CARUTH3 | PO BOX 46122 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY | $107 | — | $107 | 2.98% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DR MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $384 | $199 | $583 | 18.22% |
| WATCH TOWER TECHNOLOGIES INC3 Filed as: WATCH TOWER TECH. | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $34 | $34 | 1.06% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA DENTAL | Contract Administrator Service code 13 | — | $9K |
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 | 176 | 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) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC. | 96 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 176 | $20K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 176 | $23K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 176 | $16K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 181 | $894K |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 176 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 181 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.