| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN BENEFITS CONSULTING LLC3 | 99 PARK AVENUE 25TH FLOOR NEW YORK, NY 10016 | SECURIAN LIFE INSURANCE COMPANY | — | $11K | $11K | 2.75% |
| SURVIVOR OUTREACH SERVICES3 | 2591 DALLAS PARKWAY, SUITE 203 FRISCO, TX 75034 | SECURIAN LIFE INSURANCE COMPANY | — | $329 | $329 | 0.08% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS/BLUE SHIELD MINNESOTA EIN 41-0984460 NONE | Claims processing; Contract Administrator; Other fees; Direct payment from the plan; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $54K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $51K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $39K |
| U.S. BANK EIN 41-0417860 NONE | Investment advisory (participants); Direct payment from the plan Service code 26 | — | $16K |
| MILLIMAN EIN 91-0675641 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $16K |
| CB TRACY EIN 23-2366731 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $6K |
| EXPRESS SCRIPTS INC. EIN 43-1420563 NONE | Direct payment from the plan; Contract Administrator; Claims processing Service code 12 | — | $6K |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3,656 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,656 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 0 | $114K |
| Dental | DELTA DENTAL | 179 | $48K |
| Vision | VISION SERVICE PLAN | 31 | $3K |
| Life insurance | SECURIAN LIFE INSURANCE COMPANY | 1,119 | $418K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,119 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.