| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 301 SOUTH COLLEGE STREET 19TH FLOOR CHARLOTTE, NC 28202 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $47K | $0 | $47K | 1.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203312 DALLAS, TX 75320 | DELTA DENTAL MN | $26K | $0 | $26K | 8.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS., INC. | 4300 MARKET POINTE DRIVE SUITE 600 BLOOMINGTON, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $37K | $0 | $37K | 17.00% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SVCS., INC. | 400 HIGHWAY 169 SOUTH ST LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $4K | $4K | 1.75% |
| WELLS FARGO INSURANCE SERVICES3 | 400 HIGHWAY 169 SOUTH 8TH FLOOR ST LOUIS PARK, MN 55426 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $7K | $0 | $7K | 9.97% |
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 | 628 | 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) | 628 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 1,082 | $4.4M |
| Dental | DELTA DENTAL MN | 706 | $325K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 525 | $69K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 628 | $215K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 628 | $215K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 1,082 | $4.4M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 628 | $215K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,082 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.