| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - SHAWN E SHIBLEY | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $133K | $13K | $145K | 1.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - JACK DUFFY | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $81K | $3K | $84K | 0.72% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - BRIDGET A GILMAN | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $74K | $7K | $81K | 0.69% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - AMANDA R PURNICK | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $37K | $5K | $42K | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - RYAN REGER | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $39K | $3K | $42K | 0.36% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - SHELLY MARIE STARK | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $34K | $5K | $39K | 0.33% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - CASSANDRA SMITH | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $30K | $3K | $33K | 0.28% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - MADALYN M GOODIN | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $16K | $2K | $18K | 0.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - ELIZABETH A FLYNN | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $13K | $2K | $15K | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - CALEB T GOLBERG | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $12K | $0 | $12K | 0.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - MICHAELA D OBRIEN | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $9K | $0 | $9K | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER- LAURA M KISMIC | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $370 | $0 | $370 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER - TATIANA K KINDY | 3600 AMERICAN BLVD W, STE. 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | -$16 | $0 | -$16 | -0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CAPSTONE BENEFITS GROUP, INC NONE | Direct payment from the plan; Consulting (general) Service code 16 | 6110 TECHNOLOGY CENTER DR 500 INDIANAPOLIS, IN 46278 | $134K |
| MINNESOTA COUNCIL OF NONPROFITS EIN 36-3501477 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $39K |
| CLIFTONLARSONALLEN EIN 41-0746749 NONE | Accounting (including auditing); Trustee (individual) Service code 10 | — | $19K |
| ADAMS AND REESE LLP NONE | Legal; Direct payment from the plan Service code 29 | 1901 6TH AVENUE NORTH, SUITE 3000 BIRMINGHAM, AL 35203 | $9K |
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 | 1,200 | 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) | 1,200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 1,200 | $11.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,200 | — |
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."
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.