| 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 | $21K | — | $21K | 2.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MN EIN 41-0984460 NONE | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Float revenue Service code 12 | — | $3.2M |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Non-monetary compensation; Claims processing; Participant communication; Contract Administrator; Named fiduciary; Direct payment from the plan; Other services; Float revenue Service code 12 | — | $1.4M |
| HEALTH FITNESS CORP EIN 41-1580506 NONE | Employee (plan); Direct payment from the plan Service code 30 | — | $675K |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Contract Administrator; Claims processing; Direct payment from the plan Service code 12 | — | $434K |
| MILLIMAN EIN 91-0675641 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $336K |
| SELECTACCOUNT EIN 41-6019132 NONE | Contract Administrator; Claims processing Service code 12 | — | $170K |
| CB TRACY EIN 23-2366731 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $116K |
| TFG PARTNERS LLC EIN 14-1898306 NONE | Contract Administrator Service code 13 | — | $76K |
| PAYFLEX EIN 91-1774434 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $42K |
| AON HEWITT EIN 36-2237591 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $40K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $39K |
| ADP NATIONAL ACCOUNT SERVICES EIN 22-1467904 NONE | Contract Administrator Service code 13 | — | $29K |
| TOWERS WATSON DELAWARE INC EIN 26-0775680 NONE | Direct payment from the plan; Actuarial Service code 11 | — | $16K |
| BUCK CONSULTANTS EIN 13-3954297 NONE | Direct payment from the plan; Consulting (pension) Service code 17 | — | $8K |
| INNERWORKINGS, INC EIN 20-3707244 NONE | Other services; Direct payment from the plan Service code 49 | — | $6K |
| SUPERVALU, INC. PHARMACIES EIN 41-0617000 PLAN SPONSOR | Direct payment from the plan; Contract Administrator Service code 13 | — | $5K |
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 | 7,503 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 178 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 7,681 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 404 | $1.8M |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF MINNESOTA | 10,098 | $5.4M |
| Vision(2 contracts) | VISION SERVICE PLAN | 8,711 | $1.0M |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 148 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 10,098 | — |
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.