Form 5500 · Employee benefit plan · FORT ATKINSON, WI
OPPORTUNITIES, INC. OF JEFFERSON COUNTY
OPPORTUNITIES, INC. OF JEFFERSON COUNTY of FORT ATKINSON, WI spreads its employee benefits across 6 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is M3 INSURANCE SOLUTIONS INC.. Coverage is written through QUARTZ HEALTH BENEFIT PLANS CORPORATION and 5 other carriers. The plan's most recent policy period ended in July.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 39-1078133 · plan 510 · plan year 2025, filed Jan 23, 2026
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How this plan is funded
Fully insured as reported
The filing reports medical coverage through an insurance contract on Schedule A, and no money paid for benefits by the plan itself.
Benefits declared on this filing
Also declared: death benefits, other welfare.
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
Schedule A lists 10 insured contracts covering health, dental, vision, life and disability; the largest, with QUARTZ HEALTH BENEFIT PLANS CORPORATION, covers 141 people.
Reported premium across the insured contracts is $1,288,022, with $54,334 in disclosed broker commissions — about 4.2% of premium.
The most recent policy period ended in July, and the plan year ends July 31. Group contracts typically renew on that annual cycle.
M3 INSURANCE SOLUTIONS INC. is the broker of record on 8 of the 10 contracts; the rest name a different broker or none.
6 carriers appear on the filing, including QUARTZ HEALTH BENEFIT PLANS CORPORATION, DELTA DENTAL OF WISCONSIN, AFLAC and RELIANCE STANDARD LIFE INSURANCE COMPANY. QUARTZ HEALTH BENEFIT PLANS CORPORATION writes the largest contract by premium.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| QUARTZ HEALTH BENEFIT PLANS CORPORATION | Health | 141 | Aug 1, 2025 | $1,137,702 | $43,387 |
| DELTA DENTAL OF WISCONSIN | Dental | 105 | Aug 1, 2025 | $97,805 | $5,915 |
| AFLAC | Life, Disability | 21 | Aug 1, 2025 | $18,885 | $2,047 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Health | 13 | Aug 1, 2025 | $13,286 | $1,661 |
| WYSSTA INSURANCE COMPANY INC | Vision | 88 | Aug 1, 2025 | $11,211 | $565 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Dental | 12 | Aug 1, 2025 | $3,253 | $488 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Disability | 8 | Aug 1, 2025 | $1,487 | $223 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Life | 8 | Aug 1, 2025 | $323 | $48 |
| RELIANCE STANDARD LIFE INSURANCE COMPANY | Health | 13 | Aug 1, 2025 | $4,070 | $0 |
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 171 | Aug 1, 2025 | — | $0 |
Premium and claims on this contract
DELTA DENTAL OF WISCONSIN, contract 09922 00000. For the contract year on this filing, the carrier reported $97,123 in premium earned and $55,024 in claims incurred. Dividing one by the other gives 57%.
- DELTA DENTAL OF WISCONSIN, contract 09922 00000 reported $21,873 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
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.
Other plans filed by this employer
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