| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 3113 W BELTLINE HWY MADISON, WI 53713 | UNUM LIFE INSURANCE COMPANY | $108K | $16K | $124K | 14.92% |
| ANSAY & ASSOCIATES LLC3 | 101 EAST GRAND AVENUE PORT WASHINGTON, WI 53074 | UNUM LIFE INSURANCE COMPANY | $11K | — | $11K | 1.31% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 3113 W BELTLINE HWY MADISON, WI 53713 | PHYSICIANS PLUS INSURANCE CORPORATION | $6K | — | $6K | 1.50% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | PO BOX 8950 MADISON, WI 53708 | RELIASTAR LIFE INSURANCE COMPAN | $18K | — | $18K | 14.89% |
| ANSAY & ASSOCIATES LLC3 Filed as: ANSAY & ASSOCIATES, LLC | 702 N HIGH POINT ROAD MADISON, WI 53717 | RELIASTAR LIFE INSURANCE COMPAN | $6K | — | $6K | 5.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX,INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing Service code 12 | — | $2.0M |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $366K |
| DELTA DENTAL EIN 39-6094742 THIRD PARTY ADMINISTRATO | Contract Administrator Service code 13 | — | $53K |
| ANSAY & ASSOCIATES EIN 27-1304628 BROKER | Insurance agents and brokers Service code 22 | — | $24K |
| NATIONAL VISION ADMINISTRATORS EIN 74-3033381 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | — | $11K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 CLAIMS PROCESSING | Claims processing Service code 12 | — | $3K |
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 | 1,314 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PHYSICIANS PLUS INSURANCE CORPORATION | 57 | $407K |
| Life insurance | UNUM LIFE INSURANCE COMPANY | 1,268 | $830K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY | 1,268 | $830K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY | 1,268 | $830K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 989 | $882K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY | 1,375 | $953K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,375 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.