| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $127K | $6K | $133K | 3.15% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP, LLC | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | MEDICA INSURANCE COMPANY | $204 | $6K | $6K | 0.15% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | HARTFORD LIFE AND ACCIDENT | $17K | $0 | $17K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $3K | $0 | $3K | 10.70% |
| ASSOCIATED FINANCIAL GROUP LLC3 Filed as: ASSOCIATED FINANCIAL GROUP | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $4 | $0 | $4 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 3600 AMERICAN BOULEVARD WEST SUITE 500 BLOOMINGTON, MN 55431 | FEDERAL INSURANCE COMPANY | $1K | $0 | $1K | 15.00% |
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 | 328 | 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) | 328 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 583 | $4.2M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 457 | $28K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 328 | $113K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 328 | $113K |
| Prescription drug | MEDICA INSURANCE COMPANY | 583 | $4.2M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 328 | $120K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 583 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.