| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 13.37% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA | 11220 ASSETT LOOP STE 304 MANSASSAS, VA 20109 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $886 | $886 | 3.55% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE | $791 | $61 | $852 | 7.38% |
| LORI OLSON3 | 5280 ANNAPOLIS LN, N PLYMOUTH, MN 55446 | COLONIAL LIFE | $216 | $15 | $231 | 2.00% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE | $88 | $38 | $126 | 1.09% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE | $95 | $7 | $102 | 0.88% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE | $60 | $3 | $63 | 0.55% |
| ROBERT SCOTT BRUNER3 | 2462 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE | $31 | $17 | $48 | 0.42% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 886 POPLAR LN WATERTOWN, MN 55338 | COLONIAL LIFE | $40 | $8 | $48 | 0.42% |
| MALLORY DANAE AITCHISON3 | 5793 SPIRIT HILLS RD MONTICELLO, MN 55362 | COLONIAL LIFE | $44 | $0 | $44 | 0.38% |
| MEGAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE | $37 | $2 | $39 | 0.34% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE | $32 | $1 | $33 | 0.29% |
| ATB INSURANCE INC3 | 6505 DEMPSEY AVE SW WAVERLY, MN 55390 | COLONIAL LIFE | $10 | $0 | $10 | 0.09% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE | $4 | $3 | $7 | 0.06% |
| AUSTIN BOHLER3 | 6505 DEMPSEY AVE SW WAVERLY, MN 55390 | COLONIAL LIFE | $7 | $0 | $7 | 0.06% |
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 | 129 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 129 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPANY | 108 | $6K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 129 | $37K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 129 | $25K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 129 | $25K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 129 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 129 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.