| 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 | 2.70% |
| SURVIVOR OUTREACH SERVICES3 | 2591 DALLAS PARKWAY, SUITE 203 FRISCO, TX 75034 | SECURIAN LIFE INSURANCE COMPANY | — | $916 | $916 | 0.23% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Non-monetary compensation; Other services; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan; Named fiduciary; Claims processing Service code 12 | — | $58K |
| BLUE CROSS/BLUE SHIELD MINNESOTA EIN 41-0984460 NONE | Other fees; Direct payment from the plan; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Float revenue Service code 12 | — | $32K |
| EIDE BAILLY LLP EIN 45-0250958 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $29K |
| U.S. BANK EIN 41-0417860 NONE | Investment advisory (participants); Direct payment from the plan Service code 26 | — | $18K |
| MILLIMAN EIN 91-0675641 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $12K |
| CB TRACY EIN 23-2366731 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $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 | 1,365 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,365 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK | 0 | $224K |
| Dental | DELTA DENTAL | 145 | $43K |
| Vision | VISION SERVICE PLAN | 30 | $3K |
| Life insurance(2 contracts, 2 carriers) | SECURIAN LIFE INSURANCE COMPANY | 1,726 | $409K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,726 | — |
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."
No prospect flags tripped on this filing.