| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| STUART MIGDON3 | 900 RTE 9 NORTH SUITE 503 WOODBRIDGE, NJ 07095 | AETNA LIFE INSURANCE CO | $30K | — | $30K | 1.81% |
| ALTERITY GROUP3 Filed as: ALTERITY GROUP LLC | 340 MADISON AVE 21ST FLOOR NEW YORK, NY 10017 | SUN LIFE AND HEALTH INSURANCE COMPANY US | $77K | — | $77K | 4.89% |
| STUART MIGDON3 | 900 ROUTE 9 NORTH SUITE 503 WOODBRIDGE, NJ 07095 | KAISER FOUNDATION HEALTH PLANS INC | $26K | — | $26K | 2.77% |
| STUART MIGDON3 | 900 ROUTE 9 N STE 503 WOODBRIDGE, NJ 07095 | KAISER FOUNDATION HEALTH PLANS INC | $22K | — | $22K | 2.74% |
| STUART MIGDON3 | 900 RTE 9 N STE 503 WOODBRIDGE, NJ 07095 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $7K | — | $7K | 1.05% |
| STUART MIGDON3 | 900 RTE 9 N STE 503 WOODBRIDGE, NJ 07095 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $10K | — | $10K | 1.72% |
| STUART MIGDON3 | 900 RTE 9 NORTH SUITE 503 WOODBRIDGE, NJ 07095 | AETNA LIFE INSURANCE CO | $15K | — | $15K | 2.94% |
| STUART MIGDON3 | 900 RTE 9 N STE 503 WOODBRIDGE, NJ 07095 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $5K | — | $5K | 1.38% |
| STUART MIGDON3 | 900 RTE 9 N STE 503 WOODBRIDGE, NJ 07095 | CIGNA LIFE INSURANCE CO OF NEW YORK | $5K | — | $5K | 2.02% |
| STUART DUNKLE3 Filed as: STUART M MIGDON | 900 US HIGHWAY 9 N SUITE 503 WOODBRIDGE, NJ 07095 | DELTA DENTAL OF MINNESOTA | $4K | — | $4K | 2.15% |
| STUART MIGDON3 | 900 RTE 9 N STE 503 WOODBRIDGE, NJ 07095 | CIGNA LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 2.55% |
| STUART MIGDON3 | 900 RTE 9 N STE 503 WOODBRIDGE, NJ 07095 | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | $5K | — | $5K | 7.54% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $4K | — | $4K | 11.61% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $959 | — | $959 | 2.89% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $383 | — | $383 | 1.15% |
| EDWARD D SOMMER3 Filed as: EDWARD CHRIS ROSENLUND | 8672 MEADOWVALE DRIVE EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $285 | — | $285 | 0.86% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $161 | — | $161 | 0.49% |
| TAMMY M DAHLBERG3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $77 | — | $77 | 0.23% |
| ANDREW JAMIN GRIMSLEY3 Filed as: ANDREW JAMIN GRINSLEY | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $50 | — | $50 | 0.15% |
| SANABTHA L GRIMSLEY3 | 111 RAMBLING CREEK DR SAINT MICHAEL, MN 55376 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $38 | — | $38 | 0.11% |
| JACK ALAN HENNINGSGAARD3 | 2562 LOFT LAKE RD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | $19 | — | $19 | 0.06% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | — | — | $0 | 0.00% |
| EDWARD D SOMMER3 Filed as: EDWARD CHRIS ROSENLUND | 8672 MEADOWVALE DRIVE EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INURANCE COMPANY | — | — | $0 | 0.00% |
| STUART DUNKLE3 Filed as: STUART MICHAEL MIGDON | 900 ROUTE 9 NORTH SUITE 503 WOODBRIDGE, NJ 07095 | HARTFORD LIFE INSURANCE CO | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 CLAIMS PROCESSOR | Other services; Non-monetary compensation; Claims processing; Direct payment from the plan; Float revenue; Named fiduciary; Participant communication; Contract Administrator Service code 12 | — | $2.3M |
| STUART MIGDON BROKER | Securities brokerage commissions and fees Service code 71 | 900 US HIGHWAY 9 N STE 503 WOODBRIDGE, NJ 07095 | $164K |
| CIGNA | Float revenue; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Contract Administrator; Other services; Claims processing Service code 12 | — | $0 |
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 | 5,150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 5,152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLANS INC | 192 | $1.8M |
| Dental(3 contracts, 2 carriers) | AETNA LIFE INSURANCE CO | 4,569 | $2.4M |
| Vision | UNTITED HEALTHCARE INSURANCE COMPANY | 2,338 | $287K |
| Life insurance | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 5,150 | $641K |
| Short-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 1,495 | $394K |
| Long-term disability | CIGNA LIFE INSURANCE COMPANY OF NEW YORK | 3,287 | $555K |
| Stop-loss / reinsurancereinsurance | SUN LIFE AND HEALTH INSURANCE COMPANY US | 3,244 | $1.6M |
| Other(5 contracts, 5 carriers) | CIGNA LIFE INSURANCE CO OF NEW YORK | 5,150 | $506K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,150 | — |
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.