| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INS. SERVICES, INC. | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $82K | $16K | $97K | 15.66% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET, SUITE 5200 CHICAGO, IL 60606 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $9K | $9K | 1.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 2.97% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | UNKNOWN CRANSTON, RI 02920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $64 | $2K | 2.10% |
| MJ INSURANCE3 Filed as: LINDA R. MARCUM AND VARIOUS AGENTS | 1147 NORTH BROAD STREET LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $987 | $6 | $993 | 1.20% |
| JACQUELINE BARTHELEMY3 | 7573 HILLTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $931 | $2 | $933 | 1.13% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DRIVE RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $329 | $0 | $329 | 0.40% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INS. SERVICES, INC. | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $229 | $38 | $267 | 0.32% |
| MEGAN MOFFATT LUCAS3 | 2560 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $227 | $0 | $227 | 0.27% |
| BROWN & BROWN INSURANCE SERVICES3 Filed as: BROWN & BROWN INS. SERVICES, INC. | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $11K | $0 | $11K | 16.61% |
| R WORLD, INC.4 Filed as: R WORLD INC | PO BOX 330 MERRIFIELD, MN 56465 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $914 | $0 | $914 | 6.45% |
| BROWN & BROWN INSURANCE SERVICES4 Filed as: BROWN & BROWN INS. SERVICES, INC. | 901 MARQUETTE AVENUE MINNEAPOLIS, MN 55402 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $112 | $0 | $112 | 0.79% |
| HEALTH SOURCE AMERICA, LLC4 | 211 CARDINAL DRIVE MANKATO, MN 56001 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $74 | $0 | $74 | 0.52% |
| DAVID J. KLEINSMITH4 | PO BOX 610 MAPLE HILL, KS 66507 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $46 | $0 | $46 | 0.32% |
| K C A MARKETING INC4 | PO BOX 1702 MAPLE GROVE, MN 55311 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | $0 | $29 | 0.20% |
| JON LIPPERT4 | 405 HIGHLAND ROAD WILLMAR, MN 56201 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | $0 | $29 | 0.20% |
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 | 610 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 612 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 869 | $65K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 610 | $622K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 610 | $705K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 610 | $622K |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 610 | $719K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 869 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.