| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COMMUNITY INSURANCE BROKERAGE INC D3 Filed as: COMMUNITY INS BROKERAGE INC DBA COM | 326 BROADWAY ST PO BOX 249 CLEVELAND, MN 56017 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $40K | — | $40K | 2.78% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LANE NORTH #178 PLYMOUTH, MN 55447 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $25K | — | $25K | 1.74% |
| COMMUNITY INSURANCE BROKERAGE INC D3 | PO BOX 249 CLEVELAND, MN 56017 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 3.76% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LN N #178 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 3.24% |
| COMMUNITY INSURANCE BROKERAGE INC D3 Filed as: COMMUNITY INS BROKERAGE INC DBA | 326 BROADWAY ST PO BOX 249 CLEVELAND, MN 56017 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $2K | — | $2K | 6.59% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LANE NORTH #178 PLYMOUTH, MN 55447 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $1K | — | $1K | 3.41% |
| COMMUNITY INSURANCE BROKERAGE INC D3 | PO BOX 249 CLEVELAND, MN 56017 | SUN LIFE ASSURANCE COMPANY OF CANADA | $259 | — | $259 | 8.51% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LN N #178 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $161 | — | $161 | 5.29% |
| COMMUNITY INSURANCE BROKERAGE INC D3 | PO BOX 249 CLEVELAND, MN 56017 | SUN LIFE ASSURANCE COMPANY OF CANADA | $77 | — | $77 | 3.75% |
| 20/20 ADVISOR GROUP3 | 3500 VICKSBURG LN N #178 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $66 | — | $66 | 3.22% |
| COMMUNITY INSURANCE BROKERAGE INC D3 | PO BOX 249 CLEVELAND, MN 56017 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31 | — | $31 | 7.99% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LN N #178 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $23 | — | $23 | 5.93% |
| COMMUNITY INSURANCE BROKERAGE INC D3 | PO BOX 249 CLEVELAND, MN 56017 | SUN LIFE ASSURANCE COMPANY OF CANADA | $11 | — | $11 | 8.21% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LN N #178 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8 | — | $8 | 5.97% |
| COMMUNITY INSURANCE BROKERAGE INC D3 | PO BOX 249 CLEVELAND, MN 56017 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5 | — | $5 | 8.33% |
| 20/20 ADVISOR GROUP3 Filed as: 20/20 ADVISOR GROUP LLC | 3500 VICKSBURG LN N #178 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3 | — | $3 | 5.00% |
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 | 109 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 187 | $1.4M |
| Dental | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 109 | $35K |
| Life insurance(4 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 109 | $39K |
| Other(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 109 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 187 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.