| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PROTECTIVE FINANCIAL SOLUTIONS INC3 | 33408 BREEZY SHORES ROAD PO BOX 207 OTTERTAIL, MN 56571 | DELTA DENTAL OF MINNESOTA | $10K | — | $10K | 10.11% |
| PROTECTIVE FINANCIAL SOLUTIONS INC3 | PO BOX 207 OTTERTAIL, MN 56571 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 15.00% |
| BENEUSA LLC3 | 261 SCHOOL AVENUE SUITE 350 EXCELSIOR, MN 55331 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| PROTECTIVE FINANCIAL SOLUTIONS INC3 | PO BOX 207 OTTERTAIL, MN 56571 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| BENEUSA LLC3 | 261 SCHOOL AVENUE SUITE 350 EXCELSIOR, MN 55331 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 5.00% |
| PROTECTIVE FINANCIAL SOLUTIONS INC3 Filed as: PROTECTIVE FINANCIAL-ERIC HERMANN | 32412 355 STREET DENT, MN 56528 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 133 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 132 | $1.1M |
| Dental | DELTA DENTAL OF MINNESOTA | 199 | $98K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 82 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 188 | $64K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 188 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.