| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | $13K | — | $13K | 0.59% |
| M3 INSURANCE SOLUTIONS INC3 Filed as: M3 INSURANCE SOLUTIONS, INC. | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | $4K | $21K | 12.60% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 17TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $361 | $1K | 4.17% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $917 | — | $917 | 2.64% |
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 | 413 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WISCONSIN PHYSICIANS SERVICE INSURANCE CORPORATION | 276 | $2.1M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $167K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 267 | $167K |
| Life insurance | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 103 | $35K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 103 | $35K |
| Other | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 103 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.