| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP, INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, WI 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 48.48% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 6.92% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | VISION SERVICE PLAN | $2K | — | $2K | 3.97% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| NETWORK HEALTH PLAN EIN 46-2966177 TPA | Other insurance wrap fees; Plan Administrator; Claims processing; Insurance services; Other insurance fees and expenses Service code 12 | — | $322K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA | Contract Administrator Service code 13 | — | $15K |
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 | 462 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 462 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 255 | $38K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 462 | $45K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 447 | $192K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 462 | $113K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 121 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 462 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.