| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 61187 VIRGINIA BEACH, VA 23466 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $17K | $0 | $17K | 3.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $4 | $2K | 3.40% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $781 | $227 | $1K | 1.66% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH M. LANGEVIN & VAR. AGENTS | 698 WEST LARPENTEUR AVENUE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $772 | $76 | $848 | 1.40% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC. | 1009 8TH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $614 | $81 | $695 | 1.15% |
| EMPLOYEE BENEFIT ADVANTAGES INC3 Filed as: EMPLOYEE BENEFIT ADVANTAGES INC. | 14740 BOWERS DRIVE NW RAMSEY, MN 55303 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $628 | $0 | $628 | 1.04% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $230 | $30 | $260 | 0.43% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT | 12741 JEFFERSON STREET NE BLAINE, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $20 | $210 | 0.35% |
| STEVE BAKER3 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $2K | $0 | $2K | 21.88% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55413 | PRE-PAID LEGAL SERVICES, INC., DBA LEGALSHIELD | $204 | $0 | $204 | 1.85% |
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 | 1,397 | 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) | 1,397 | 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. | 1,128 | $88K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,166 | $509K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 139 | $61K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,166 | $509K |
| Other(4 contracts, 4 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,397 | $555K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,397 | — |
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.