| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH, 8TH FLOOR SAINT LOUIS PARK, MN 55426 | HARTFORD LIFE AND ACCIDENT | $7K | $0 | $7K | 1.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH, SUITE 800 MINNEAPOLIS, MN 55426 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $0 | $4K | 5.08% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 3.48% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH LANGEVIN AND OTHER AGENTS | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $355 | $2K | 2.64% |
| EMPLOYEE BENEFIT ADVANTAGES INC3 Filed as: EMPLOYEE BENEFIT ADVANTAGES, INC. | 14740 BOWERS DRIVE NW RAMSEY, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $3 | $2K | 2.12% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $132 | $1K | 1.58% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN MOFFET LUCAS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $557 | $170 | $727 | 0.98% |
| TAMMY M DAHLBERG3 Filed as: TAMMY M. DAHLBERG | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $470 | $65 | $535 | 0.72% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $3K | $0 | $3K | 22.75% |
| GALLAGHER BENEFIT SERVICES, INC.4 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $753 | $0 | $753 | 5.59% |
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 | 1,318 | 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) | 1,318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE | 1,013 | $66K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,318 | $637K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 170 | $74K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,318 | $637K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,318 | $668K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,318 | — |
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.