| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 | — | BLUECROSS BLUESHIELD OF ILLINOIS | $19K | — | $19K | 2.83% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL | — | BLUECROSS BLUESHIELD OF ILLINOIS | — | $600 | $600 | 0.09% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DEAN HEALTH PLAN INC | $10K | — | $10K | 2.97% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF ILLINOIS | $3K | — | $3K | 6.27% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $324 | $5K | 16.03% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER BENEFITS LLC | 2734 N MILDRED AVE #3 CHICAGO, IL 60618 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $86 | — | $86 | 0.26% |
| THIRD COAST ADVISORS INC3 | — | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $49 | — | $49 | 0.15% |
| C2 CENTRIC LLC3 Filed as: C2 CENTRIC, LLC | 11740 SW 68TH PARKWAY, SUITE 2 PORTLAND, OR 97223 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $33 | — | $33 | 0.10% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 8.16% |
| GCG FINANCIAL LLC3 | 3 PARKWAY N STE 500 DEERFIELD, IL 60015 | METROPOLITAN LIFE INSURANCE COMPANY | — | $79 | $79 | 0.30% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | VISION SERVICE PLAN | $550 | — | $550 | 11.49% |
| GCG FINANCIAL LLC3 Filed as: GCG FINANCIAL | 3 PARKWAY NORTH BLVD STE 500 DEERFIELD, IL 60015 | VISION SERVICE PLAN | $51 | — | $51 | 1.07% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | SUPERIOR VISION PLAN | $266 | — | $266 | — |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $259 | — | $259 | — |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUECROSS BLUESHIELD OF ILLINOIS | 73 | $1.0M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF ILLINOIS | 50 | $49K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 58 | $5K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 127 | $60K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 31 | $33K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 31 | $33K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 127 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 127 | — |
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.