Form 5500 · Employee benefit plan · MADISON, WI
GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WI
The filing calls this plan GROUP HEALTH COOPERATIVE LONG TERM DISABILITY PLAN.
Public Form 5500 records show how GROUP HEALTH COOPERATIVE OF SOUTH CENTRAL WI of MADISON, WI, a health care and social assistance employer, structures its employee benefits. Its broker of record is M3 INSURANCE SOLUTIONS INC.. Coverage is written through LIFE INSURANCE COMPANY OF NORTH AMERICA. The plan's most recent policy period ended in September.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1199466 · plan 503 · plan year 2024, filed Jul 7, 2025
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75 other employer plans in Wisconsin have policy years ending in September. See the full list on the renewal calendar, or ask for it in Claude or ChatGPT.
How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
All 2 insured contracts are disability coverage with LIFE INSURANCE COMPANY OF NORTH AMERICA.
Reported premium across the insured contracts is $504,720, with $11,271 in disclosed broker commissions — about 2.2% of premium.
The most recent policy period ended in September, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
M3 INSURANCE SOLUTIONS INC. is the broker of record on all 2 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 684 | Oct 1, 2024 | $259,350 | $6,594 |
| LIFE INSURANCE COMPANY OF NORTH AMERICA | Disability | 684 | Oct 1, 2024 | $245,370 | $4,677 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 16 employees, 0 recordable cases, 0 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Other plans filed by this employer
How this plan compares
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Renewal calendar
75 other employer plans in Wisconsin are October 1 renewals (policy year ends September).
Their policy years end in September, like this plan’s, so most renew October 1. The calendar lists every insured group by renewal date and state, with broker of record, carrier and disclosed commission. You can preview the five largest in each month for free.
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