| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES, INC. | PO BOX 346 AVON, MN 56310 | MEDICA INSURANCE COMPANY | $26K | $0 | $26K | 1.96% |
| BENE USA LLC3 Filed as: BENE USA, LLC | 1851 LAKE DRIVE WEST, SUITE 350 CHANHASSEN, MN 55317 | UNION SECURITY INSURANCE COMPANY | $0 | $4K | $4K | 5.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES, INC | PO BOX 346 AVON, MN 56310 | UNION SECURITY INSURANCE COMPANY | $3K | $0 | $3K | 4.13% |
| JACKI M BARTHELEMY3 Filed as: JACKI M. BARTHELEMY | 7573 HILLTON ROAD ROYALTON, MN 56373 | UNION SECURITY INSURANCE COMPANY | $3K | $0 | $3K | 4.13% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 12.20% |
| ASHLEY MARIA BARTHELEMY3 | 4011 BRADDOCK AVENUE NE BUFFALO, MN 55313 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $335 | $2K | 3.47% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $908 | $518 | $1K | 2.30% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH LANGEVIN AND OTHER AGENTS | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $834 | $185 | $1K | 1.64% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 1401 5TH AVENUE SE, APARTMENT 102 LITTLE FALLS, MN 56345 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $896 | $5 | $901 | 1.45% |
| ADVISORNET FINANCIAL, INC.3 | 701 4TH AVENUE SOUTH MINNEAPOLIS, MN 55415 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $521 | $0 | $521 | 0.84% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $358 | $162 | $520 | 0.84% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES, INC. | PO BOX 346 AVON, MN 56310 | SUN LIFE ASSURANCE COMPANY OF CANADA | $495 | $0 | $495 | 6.88% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | SUN LIFE ASSURANCE COMPANY OF CANADA | $495 | $0 | $495 | 6.88% |
| BENE USA LLC3 Filed as: BENE USA, LLC | 1851 LAKE DRIVE WEST, SUITE 350 CHANHASSEN, MN 55317 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $330 | $330 | 4.58% |
No Schedule C service providers reported on this filing.
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 | 230 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 171 | $1.3M |
| Dental | UNION SECURITY INSURANCE COMPANY | 109 | $75K |
| Vision | UNION SECURITY INSURANCE COMPANY | 109 | $75K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 236 | $69K |
| Long-term disability(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 236 | $69K |
| Prescription drug | MEDICA INSURANCE COMPANY | 171 | $1.3M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 236 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.