| 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 537131424 | UNITY HEALTH PLANS INSURANCE CORPORATION | $21K | — | $21K | 1.25% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 6.79% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 13.44% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 15.00% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVENUE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $37 | $37 | 0.27% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 537131424 | WYSSTA INSURANCE COMPANY, INC. | $941 | — | $941 | 8.04% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $831 | — | $831 | 11.75% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 15.01% |
| C2 CENTRIC LLC3 | 2209 GODWIN AVE GRAND RAPIDS, MI 49507 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $20 | $20 | 0.29% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 221 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITY HEALTH PLANS INSURANCE CORPORATION | 338 | $1.6M |
| Vision | WYSSTA INSURANCE COMPANY, INC. | 99 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $43K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $21K |
| Prescription drug | UNITY HEALTH PLANS INSURANCE CORPORATION | 338 | $1.6M |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $27K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 338 | — |
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.