| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HEALTHPARTNERS INSURANCE COMPANY | $65K | $79 | $65K | 3.37% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $24K | $12K | $35K | 22.33% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $415 | $204 | $619 | 4.80% |
| WESTLUND ASSOCIATES3 Filed as: WESTLUND ASSOCIATES INC. | PO BOX 668 HUTCHINSON, MN 55350 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $592 | $0 | $592 | 4.59% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $340 | $0 | $340 | 2.64% |
| MJ INSURANCE3 Filed as: JILL R. LAMBERT AND VARIOUS AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $186 | $26 | $212 | 1.64% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC. | 886 POPLAR LANE WATERTOWN, MN 55388 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $123 | $10 | $133 | 1.03% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $4 | $83 | 0.64% |
| ATB INSURANCE INC3 Filed as: ATB INSURANCE INC. | 6505 DEMPSEY AVENUE SW WAVERLY, MN 55390 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $65 | $3 | $68 | 0.53% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.79% |
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 | 214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHPARTNERS INSURANCE COMPANY | 292 | $1.9M |
| Dental | HEALTHPARTNERS INSURANCE COMPANY | 292 | $1.9M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 150 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $159K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $159K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $159K |
| Prescription drug | HEALTHPARTNERS INSURANCE COMPANY | 292 | $1.9M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 289 | $226K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 292 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.