| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFITS PLANS CORPORATION | $16K | $0 | $16K | 1.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | QUARTZ HEALTH BENEFITS PLANS CORPORATION | $6K | $0 | $6K | 0.69% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $793 | $5K | 8.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 4.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $192 | $192 | 0.31% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | UNUM INSURANCE COMPANY | $1K | $201 | $1K | 14.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | UNUM INSURANCE COMPANY | $327 | $0 | $327 | 3.47% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNUM INSURANCE COMPANY | $0 | $17 | $17 | 0.18% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLAN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $233 | $0 | $233 | 3.95% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 245 SOUTH EXECUTIVE DRIVE SUITE 200 BROOKFIELD, WI 53005 | WYSSTA INSURANCE COMPANY INC | $233 | $0 | $233 | 3.95% |
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 | 85 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 86 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFITS PLANS CORPORATION | 147 | $937K |
| Vision | WYSSTA INSURANCE COMPANY INC | 40 | $6K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $62K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $62K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $62K |
| Prescription drug | QUARTZ HEALTH BENEFITS PLANS CORPORATION | 147 | $937K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 86 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.