| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | QUARTZ HEALTH BENEFIT PLANS CORPORATION | $16K | — | $16K | 1.65% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $3K | — | $3K | 6.70% |
| M3 INSURANCE SOLUTIONS INC3 | P O BOX 8950 828 JOHN NOLEN DRIVE MADISON, WI 53708 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.44% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE AGENCY | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $110 | $110 | 0.60% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $542 | — | $542 | 3.54% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLAN DRIVE SUITE 300 MADISON, WI 53713 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $272 | $3K | 22.22% |
| THIRD COAST ADVISORS INC3 | 1166 QUAIL COURT #100 PEWAUKEE, WI 53072 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $93 | — | $93 | 0.76% |
| C2 CENTRIC LLC3 | 11740 SW 68TH PARKWAY SUITE 2 PORTLAND, OR 97223 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5 | — | $5 | 0.04% |
| M3 INSURANCE SOLUTIONS INC3 | P O BOX 8950 828 JOHN NOLEN DRIVE MADISON, WI 53708 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE AGENCY | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $62 | $62 | 0.60% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $639 | — | $639 | 7.55% |
| M3 INSURANCE SOLUTIONS INC3 | P O BOX 8950 828 JOHN NOLEN DRIVE MADISON, WI 53708 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $843 | — | $843 | 10.00% |
| M3 INSURANCE SOLUTIONS INC3 | P O BOX 8950 828 JOHN NOLEN DRIVE MADISON, WI 53708 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $778 | — | $778 | 10.99% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE AGENCY | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $29 | $29 | 0.41% |
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 | 119 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 20 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 198 | $978K |
| Dental(2 contracts) | DELTA DENTAL OF WISCONSIN | 89 | $65K |
| Vision | WYSSTA INSURANCE COMPANY INC | 82 | $8K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 66 | $16K |
| Short-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 65 | $18K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 65 | $10K |
| Prescription drug | QUARTZ HEALTH BENEFIT PLANS CORPORATION | 198 | $978K |
| Other(3 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 66 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.