| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DEAN HEALTH PLAN INC | $15K | — | $15K | 2.41% |
| EXTERNAL AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $4K | — | $4K | 2.48% |
| NEXBEN AGENCY INC.3 Filed as: NEXBEN | — | BLUE CARE NETWORK OF MICHIGAN | $2K | — | $2K | 0.97% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | $1K | $7K | 10.90% |
| CLARITY ENROLLMENT SOLUTIONS LLC3 | PO BOX 46122 EDEN PRAIRIE, MN 55344 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 2.92% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $4K | — | $4K | 8.98% |
| EXTERNAL AGENT3 | — | BLUE CARE NETWORK OF MICHIGAN | $931 | — | $931 | 2.31% |
| NEXBEN AGENCY INC.3 Filed as: NEXBEN | — | BLUE CARE NETWORK OF MICHIGAN | $365 | — | $365 | 0.91% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $742 | — | $742 | 8.01% |
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 | 161 | 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) | 161 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | DEAN HEALTH PLAN INC | 91 | $830K |
| Dental | DELTA DENTAL OF WISCONSIN | 73 | $47K |
| Vision | WYSSTA INSURANCE COMPANY INC | 71 | $9K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 234 | $67K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 234 | $67K |
| Prescription drug(2 contracts) | BLUE CARE NETWORK OF MICHIGAN | 30 | $202K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 234 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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.