| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 3113 WEST BELTLINE HIGHWAY MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.84% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS | 3113 WEST BELTLINE HIGHWAY MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $653 | $6K | 15.76% |
| M3 INSURANCE SOLUTIONS INC3 | 3113 W BELTLING HIGHWAY MADISON, WI 53713 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $543 | — | $543 | 2.15% |
| SPETNER ASSOCIATES INC3 | 8630 DELMAR AVENUE SUITE 100 ST LOUIS, MO 63124 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $528 | — | $528 | 2.09% |
| HAMBY, JAMES, WESLEY3 | 503 FORREST PARK COURT MADISON, AL 35758 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $164 | — | $164 | 0.65% |
| EOI SERVICE COMPANY INC3 | 1820 E 1ST STREET SUITE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $136 | — | $136 | 0.54% |
| DAVIDSON JAMES DUNCAN3 Filed as: DAVIDSON, JAMES, DUNCAN | 1820 EAST 1ST SUITE 400 SANTA ANA, CA 92868 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $83 | — | $83 | 0.33% |
| SPETNER ASSOCIATES INC3 Filed as: SPETNER, JONATHAN, SAMUEL | 8630 DELMAR BOULEVARD SUITE 100 SAINT LOUIS, MO 63124 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.07% |
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 | 286 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 14 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 304 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $155K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $181K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $155K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 238 | $382K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 300 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.