| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 13965 W CHINDEN BLVD STE 300 BOISE, ID 83713 | VISION SERVICE PLAN | $23K | — | $23K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MN EIN 41-0984460 NONE | Claims processing; Accounting (including auditing); Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue Service code 10 | — | $3.1M |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $1.6M |
| HEALTH FITNESS CORP EIN 41-1580506 NONE | Direct payment from the plan; Employee (plan) Service code 30 | — | $885K |
| MILLIMAN EIN 91-0675641 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $421K |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Claims processing; Direct payment from the plan; Contract Administrator Service code 12 | — | $352K |
| SELECTACCOUNT EIN 41-6019132 NONE | Contract Administrator; Claims processing Service code 12 | — | $187K |
| SUPERVALU, INC. PHARMACIES EIN 41-0617000 PLAN SPONSOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $160K |
| CB TRACY EIN 23-2366731 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $107K |
| AON HEWITT EIN 36-2237591 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $107K |
| BUCK CONSULTANTS EIN 13-3954297 NONE | Consulting (pension); Direct payment from the plan Service code 17 | — | $99K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $84K |
| PAYFLEX EIN 91-1774434 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $52K |
| TFG PARTNERS LLC EIN 14-1898306 NONE | Contract Administrator Service code 13 | — | $42K |
| INNERWORKINGS, INC EIN 20-3707244 NONE | Direct payment from the plan; Other services Service code 49 | — | $35K |
| TOWERS WATSON DELAWARE INC EIN 26-0775680 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $28K |
| PSG CONSULTING EIN 27-2345574 NONE | Contract Administrator Service code 13 | — | $26K |
| ADP NATIONAL ACCOUNT SERVICES EIN 22-1467904 NONE | Contract Administrator Service code 13 | — | $16K |
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 | 10,893 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 372 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 11,265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 388 | $3.7M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MINNESOTA | 10,630 | $6.0M |
| Vision(2 contracts) | VISION SERVICE PLAN | 8,800 | $1.2M |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 43 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,630 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.