| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 203066 DALLAS, TX 75320 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $9K | $2K | $11K | 2.99% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 10 SOUTH WACKER DRIVE FLOOR 17 CHICAGO, IL 60606 | HARTFORD LIFE AND ACCIDENT | $0 | $10K | $10K | 4.94% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 400 HIGHWAY 169 SOUTH ST LOUIS PARK, MN 55426 | HARTFORD LIFE AND ACCIDENT | $2K | $0 | $2K | 1.23% |
| 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 | 5.90% |
| MJ INSURANCE3 Filed as: JILL R LAMBERT AND VARIOUS AGENTS | 12741 JEFFERON STREET NORTHEAST BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $445 | $3K | 4.88% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $933 | $2K | 3.70% |
| EMPLOYEE BENEFIT ADVANTAGES INC3 | 14740 BOWERS DRIVE NORTHWEST RAMSEY, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 1.69% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $532 | $132 | $664 | 1.03% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $463 | $145 | $608 | 0.95% |
| CAROLYN GROVER3 | 206 FOX CHAPEL DRIVE IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $464 | $87 | $551 | 0.86% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $2K | $0 | $2K | 19.95% |
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 | 1,237 | 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) | 1,237 | 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. | 982 | $85K |
| Life insurance(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,260 | $559K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 163 | $64K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,260 | $559K |
| Other(4 contracts, 4 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 1,260 | $585K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,260 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.