| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: HANRATTY AND ASSOCIATES INC | 9800 SHELARD PKWY STE 340 PLYMOUTH, MN 55441 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 1.21% |
| USI INSURANCE SERVICES LLC3 | ATTN MOUNTAIN MINN P O BOX 62817 VIRGINIA BEACH, VA 23466 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 0.17% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 S MICHIGAN AVE STE 100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $499 | $499 | 0.06% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $243 | $5K | 2.36% |
| ENROLLEASE3 Filed as: HANRATTY AND ASSOCIATES INC | 15350 25TH AVE N STE 114 MINNEAPOLIS, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $627 | $4K | 2.24% |
| USI INSURANCE SERVICES LLC3 | 15350 25TH AVE N PLYMOUTH, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $147 | $4K | 2.05% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE RD FRAZEE, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $35 | $3K | 1.37% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $460 | $3K | 1.35% |
| DESERIEE WENDELL3 | 40771 FENIAN WAY NORTH BRANCH, MN 55056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $901 | $11 | $912 | 0.46% |
| ASHLEY MARIA BARTHELEMY3 | 4011 BRADDOCK AVE NE BUFFALO, MN 55313 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $709 | $115 | $824 | 0.41% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 1100 11TH AVE SE SAINT CLOUD, MN 56304 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $774 | $15 | $789 | 0.40% |
| CASSANDRA LONG3 | 8629 ALDEN ST LENEXA, KS 66215 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $345 | $43 | $388 | 0.19% |
| MALINDA OLHOFT3 | 20969 130TH AVE BARRETT, MN 56311 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $339 | — | $339 | 0.17% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $204 | $125 | $329 | 0.17% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $204 | $106 | $310 | 0.16% |
| THOMAS JAMES BUTLER3 | 7913 N 164TH ST BENNINGTON, NE 68007 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $145 | $9 | $154 | 0.08% |
| ANDREW CHARLES FELLS3 | 331 W HUMPHREY ST LAKE CRYSTAL, MN 56055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $149 | — | $149 | 0.07% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LN EDEN PRAIRIE, MN 55346 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $108 | $20 | $128 | 0.06% |
| JOAN C KROEHLER3 | 35 3RD ST BANGOR, ME 04401 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $124 | — | $124 | 0.06% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.06% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $117 | — | $117 | 0.06% |
| DEBORAH ANN BERRY3 | 1042 E 9TH PL MESA, AZ 85203 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $96 | — | $96 | 0.05% |
| SANTE CONCEPTS INC3 | 94 BARTLETT WAY DALLAS, GA 30157 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 0.04% |
| RYAN BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $27 | $48 | 0.02% |
| JASON BAHR3 | 7072 FAIRVIEW RD BAXTER, MN 56425 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $10 | $46 | 0.02% |
| RON BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $22 | $44 | 0.02% |
| REBECCA J MERRITT3 | 927 EAST KEIM DR PHOENIX, AZ 85014 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.02% |
| ARLO I MATHISON3 | 28118 141ST ST NW ZIMMERMAN, MN 55398 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.01% |
| TRACY MARIE FRIELER3 | P O BOX 6 ALBANY, MN 56307 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| ROBERT E ELLIS3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $5 | $14 | 0.01% |
| CRISS BUTLER3 | 4942 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $5 | $14 | 0.01% |
| JACK ALAN HENNINGSGAARD3 | 2562 LOST LAKE RD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.00% |
| USI INSURANCE SERVICES LLC3 | P O BOX 62817 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 9.13% |
| ENROLLEASE3 Filed as: HANRATTY AND ASSOCIATES INC | 15350 25TH AVE N STE 114 PLYMOUTH, MN 55447 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 7.11% |
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 | 1,352 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,358 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,007 | $57K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,443 | $906K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,443 | $906K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,443 | $906K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 1,443 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,443 | — |
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.