| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - BRIDGET A GILMAN | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $26K | $2K | $28K | 1.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - SHAWN E SHIBLEY | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $23K | $2K | $25K | 0.91% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - KIM F GROOMES | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $17K | $719 | $18K | 0.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - MICHAELA D OBRIEN | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $16K | $424 | $17K | 0.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - MICHAEL S LYNNER | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $14K | $635 | $15K | 0.54% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - AMANDA R PURNICK | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $12K | $693 | $13K | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - JACK DUFFY | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $11K | $2K | $13K | 0.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - SHELLY MARIE STARK | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $11K | $751 | $12K | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - JOAN E KOHL | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $6K | $289 | $6K | 0.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MINNESOTA COUNCIL OF NONPROFITS EIN 36-3501477 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $20K |
| MARJORIE SIEGEL EIN 36-3501477 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $7K |
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 | 453 | 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) | 453 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 453 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 453 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.