| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS AND BLUE SHIELD OF MINNE | P.O. BOX 64560 ST. PAUL, MN 55164 | BCBSMN, INC. D.B.A BLUE CROSS BLUE SHIELD OF MINNESOTA | $0 | $6K | $6K | 2.28% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHEILD OF MINNESOTA EIN 41-0984460 BUSINESS RELATIONSHIP | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $5.0M |
| LIMEADE BUSINESS RELATIONSHIP | Other services Service code 49 | 10885 NE 4TH STREET STE 400 BELLEVUE, WA 98004 | $1.0M |
| EXPRESS SCRIPTS EIN 23-3461740 BUSINESS RELATIONSHIP | Contract Administrator; Claims processing Service code 12 | — | $579K |
| DELTA DENTAL EIN 41-1905554 BUSINESS RELATIONSHIP | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $342K |
| ADVANCE MEDICAL EIN 32-0188784 BUSINESS RELATIONSHIP | Other services Service code 49 | — | $245K |
| PRICEWATERHOUSECOPPERS LLC EIN 13-4008324 BUSINESS RELATIONSHIP | Accounting (including auditing) Service code 10 | — | $63K |
| COMERICA EIN 38-0477375 TRUSTEE & PARTY-IN-INTERE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $8K |
| YMCA EIN 45-2563299 BUSINESS RELATIONSHIP | Other services Service code 49 | — | $1K |
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 | 7,811 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 150 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 7,961 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | BCBSMN, INC. D.B.A BLUE CROSS BLUE SHIELD OF MINNESOTA | 7,811 | $269K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 7,811 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.