| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIAM A CLARK3 | 8676 WYNSTONE PASS EDEN PRAIRIE, MN 553473434 | PRINCIPAL LIFE INSURANCE CO | $31K | — | $31K | 5.04% |
| JOSEPH R HASLING3 | 5713 MATTERHORN DR NE FRIDLEY, MN 554325913 | PRINCIPAL LIFE INSURANCE CO | $31K | — | $31K | 5.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSM INC EIN 41-0984460 ADMINISTRATOR | Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Claims processing Service code 12 | — | $689K |
| DELTA DENTAL EIN 41-0952670 ADMINISTRATOR | Contract Administrator Service code 13 | — | $89K |
| PRIME THERAPEUTICS PBM | Other fees; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 1305 CORPORATE CENTER DRIVE EAGAN, MN 55121 | $43K |
| OPTUM ADMINISTRATOR | Contract Administrator Service code 13 | 11000 OPTUM CIRCLE EDEN PRAIRIE, MN 55344 | $39K |
| PRINCIPAL LIFE INS CO EIN 42-0127290 ADMINISTRATOR | Contract Administrator Service code 13 | — | $24K |
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 | 1,768 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 18 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,786 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | PRINCIPAL LIFE INSURANCE CO | 1,951 | $618K |
| Long-term disability | PRINCIPAL LIFE INSURANCE CO | 1,951 | $618K |
| Stop-loss / reinsurancereinsurance | BCBSM INC | 1,484 | $522K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,951 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.