| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $13 | $5K | 10.52% |
| MALLARY DANAE AITCHISON3 | 5793 SPIRIT HILLS RD MONTICELLO, MN 55362 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | — | $5K | 10.22% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $795 | $2K | 5.00% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $379 | $483 | $862 | 1.89% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $397 | $165 | $562 | 1.23% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $393 | $87 | $480 | 1.05% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT AND OTHER AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $257 | $111 | $368 | 0.81% |
| ATB INSURANCE INC3 Filed as: ATB INSURANCE, INC. | 6505 DEMPSEY AVENUE SW WAVERLY, MN 55390 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $224 | $10 | $234 | 0.51% |
| THE HORTON GROUP3 | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $185 | $9 | $194 | 0.43% |
| ZACHARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.11% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY ST CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | — | $32 | 0.07% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $6 | $23 | 0.05% |
| NFP INSURANCE SERVICES INC3 Filed as: NFP CORPORATE SERVICES MN INC | 505 HWY 169 N STE 1100 MINNEAPOLIS, MN 55441 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.04% |
| BILLY MARK ROBERSON3 Filed as: BILLY MARK ROBINSON | 19210 BOCA DEL MAR SAN ANTONIO, TX 78258 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.04% |
| OMAR MENDOZA3 | 26326 ROCKWELL PKWY NEW BRAUNFELS, TX 78132 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.04% |
| MANUEL FUENTES3 | 63 MARIPOSA PKWY WEST BOERNE, TX 78006 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.04% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $2 | $15 | 0.03% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE, INC. | 886 POPLAR LANE WATERTOWN, MN 55388 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 9.69% |
| THE HORTON GROUP3 | 5050 LINCOLN DRIVE, STE 460 EDINA, MN 55436 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 4.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $273 | — | $273 | 4.55% |
| THE HORTON GROUP3 | 10320 ORLAND PARKWAY ORLAND PARK, IL 60467 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $104 | — | $104 | 1.73% |
| US INSURANCE SERVICES LLC3 Filed as: US INSURANCE SERVICES | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $213 | — | $213 | 8.04% |
| THE HORTON GROUP3 | 5050 LINCOLN DRIVE, SUITE 460 EDINA, MN 55436 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $97 | — | $97 | 3.66% |
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 | 127 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | 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 ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 139 | $6K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 139 | $26K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 45 | $46K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 139 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.