| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | — | $6K | 1.51% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 2.43% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 5.00% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPT | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 7.54% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 3.86% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $590 | — | $590 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN, INC EIN 41-0984460 NONE | Claims processing; Contract Administrator; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | PO BOX 64560 ST PAUL, MN 551640560 | $260K |
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 | 779 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 781 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,202 | $421K |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 831 | $55K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 852 | $183K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 646 | $179K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 490 | $61K |
| Stop-loss / reinsurancereinsurance | BCBSMN, INC. D.B.A BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 780 | $234K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,202 | — |
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.