| 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 | STARMOUNT LIFE INSURANCE COMPANY | $9K | $5K | $14K | 3.23% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 5.00% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 3.09% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPT INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 7.03% |
| 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 | 4.40% |
| PREFERRED BENEFIT CONCEPTS, INC.3 Filed as: PREFERRED BENEFIT CONCEPTS INC | 8881 AZTEC DR EDEN PRAIRIE, MN 55347 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $764 | — | $764 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN, INC EIN 41-0984460 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Contract Administrator Service code 12 | PO BOX 64560 ST PAUL, MN 55164 | $560K |
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 | 762 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 769 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 750 | $438K |
| Vision(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 957 | $61K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 884 | $225K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 658 | $190K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 574 | $82K |
| Stop-loss / reinsurancereinsurance | BCBSMN, INC., D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 775 | $384K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 957 | — |
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.