| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | PO BOX 8950 MADISON, WI 53708 | HCC LIFE INSURANCE COMPANY | $20K | — | $20K | 2.92% |
| C2 CENTRIC LLC3 | PO BOX 6824 SUITE H GRAND RAPIDS, MI 49516 | HCC LIFE INSURANCE COMPANY | $7K | — | $7K | 1.00% |
| IMG3 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $55 | $55 | 0.02% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 8.11% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $148 | $5K | 27.78% |
| SPETNER ASSOCIATES INC3 | 8630 DELMAR AVENUE SUITE 100 ST LOUIS, MO 63124 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $136 | — | $136 | 0.83% |
| JAMES WESLEY HAMBY3 | 14008 RANDAMERE DRIVE HUNTSVILLE, AL 35803 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $41 | — | $41 | 0.25% |
| JAMES DUNCAN DAVIDSON3 | 9822 ORCHARD LANE VILLA PARK, CA 92861 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.09% |
| EOI SERVICE COMPANY INC3 | 1820 EAST 1ST STREET SUITE 400 SANTA ANA, CA 92705 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.09% |
| JONATHAN SAMUEL SPETNER3 | 8630 DELMAR BOULEVARD SUITE 100 ST LOUIS, MO 63124 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $114 | $3K | 29.05% |
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 | 330 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 54 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 386 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 212 | $26K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 318 | $250K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 318 | $250K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 318 | $234K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 235 | $676K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 318 | $261K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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."
No prospect flags tripped on this filing.