| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $143 | $6K | 3.71% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD MINNEAPOLIS, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 3.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $982 | — | $982 | 0.62% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVENUE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $893 | $3 | $896 | 0.56% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $614 | $7 | $621 | 0.39% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $454 | — | $454 | 0.29% |
| KIH INSURANCE INC3 | 6505 DEMPSEY AVENUE SW WAVERLY, MN 55390 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $416 | — | $416 | 0.26% |
| JILL R LAMBERT3 | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $356 | $4 | $360 | 0.23% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $163 | — | $163 | 0.10% |
| JON OLSON3 | 8662 CARRIAGE HILL ROAD SAVAGE, MN 55378 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $163 | — | $163 | 0.10% |
| JENNIFER COLLEEN DYNAN3 | 13674 BRONZE PARKWAY ROSEMOUNT, MN 55068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $120 | — | $120 | 0.08% |
| DESIREE WENDELL3 | 39050 HARDER PARKWAY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $109 | — | $109 | 0.07% |
| ATB INSURANCE INC3 | 6505 DEMPSEY AVENUE SW WAVERLY, MN 55390 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | $4 | $91 | 0.06% |
| ASSUREDPARTNERS3 Filed as: BERTHA PATRICIA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $13 | $67 | 0.04% |
| ZACKARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $63 | — | $63 | 0.04% |
| ASHLEY MARIA HOUTMAN3 | 3108 WESTEDGE BOULEVARD MOUND, MN 55364 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.03% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 2019 4TH AVENUE N, APT 202 SAUK RAPIDS, MN 56379 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.03% |
| RENE ADRIAN RODRIGUEZ3 | 1814 E BELL ROAD, UNIT 2009 PHOENIX, AZ 85022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.02% |
| ALEXANDER OTTONIEL CANAS3 | 26123 BOUQUET CANYON ROAD SANTA CLARITA, CA 91350 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.02% |
| CARRIE S FLATEN3 | 2606 86TH COURT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.02% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DRIVE NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $4 | $18 | 0.01% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $2 | $9 | 0.01% |
| SABRINA S RAMOS3 | 13750 W COLONIAL DRIVE WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | — | $6 | 0.00% |
| R AND T FIGUEROA LLC3 | 7569 S CARLISLE AVENUE TUCSON, AZ 85746 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.00% |
| CAROLYN GROVER3 | 206 FOX CHAPEL DRIVE IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE, SUITE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
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 | 560 | 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) | 560 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 560 | $302K |
| Long-term disability | STANDARD INSURANCE COMPANY | 172 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 560 | — |
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."
No prospect flags tripped on this filing.