| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | HEALTHPARTNERS INSURANCE COMPANY | $74K | $30 | $74K | 3.11% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $29K | $14K | $43K | 22.17% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $660 | $364 | $1K | 7.09% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $546 | $8 | $554 | 3.84% |
| WESTLUND ASSOCIATES3 Filed as: WESTLUND ASSOCIATES, INC. | PO BOX 668 HUTCHINSON, MN 55350 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $530 | $0 | $530 | 3.67% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT AND OTHER AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $364 | $45 | $409 | 2.83% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE, INC. | 886 POPLAR LANE WATERTOWN, MN 55388 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $178 | $24 | $202 | 1.40% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DRIVE RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $93 | $3 | $96 | 0.66% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $6 | $66 | 0.46% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | $0 | $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 | 216 | 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) | 216 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHPARTNERS INSURANCE COMPANY | 276 | $2.4M |
| Dental | HEALTHPARTNERS INSURANCE COMPANY | 276 | $2.4M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 129 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $195K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $195K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $195K |
| Prescription drug | HEALTHPARTNERS INSURANCE COMPANY | 276 | $2.4M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 216 | $210K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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.