| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JENNON M CARUTH3 | 7825 WASHINGTON AVENUE SOUTH #710 BLOOMINGTON, MN 55439 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 12.77% |
| WESTERN INSURANCE AGENCY INC3 | 1740 RICE STREET SUITE 200 ST PAUL, MN 55313 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.07% |
| JENNON CARUTH3 | 1331 HEATHER COURT CHANHASSEN, MN 55317 | STANDARD INSURANCE COMPANY | — | $609 | $609 | 1.91% |
| WESTERN INSURANCE AGENCY INC3 | PO BOX 919 WINONA, MN 55987 | EYEMED VISION CARE | $729 | — | $729 | 9.14% |
| WESTERN INSURANCE AGENCY INC3 | 1740 RICE STREET SUITE 200 SAINT PAUL, MN 55113 | EYEMED VISION CARE | $70 | — | $70 | 0.88% |
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 | 137 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 309 | $84K |
| Vision | EYEMED VISION CARE | 152 | $8K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 129 | $53K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $23K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 99 | $14K |
| Other(4 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 130 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.