| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | MEDICA INSURANCE COMPANY | $26K | $0 | $26K | 1.85% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES, INC. | PO BOX 346 AVON, MN 56310 | MEDICA INSURANCE COMPANY | $4K | $0 | $4K | 0.30% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | UNION SECURITY INSURANCE COMPANY | $6K | $0 | $6K | 7.59% |
| BENE USA LLC3 Filed as: BENE USA, LLC | 1851 LAKE DRIVE WEST, SUITE 350 CHANHASSEN, MN 55317 | UNION SECURITY INSURANCE COMPANY | $0 | $998 | $998 | 1.29% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES, INC. | PO BOX 346 AVON, MN 56310 | UNION SECURITY INSURANCE COMPANY | $264 | $0 | $264 | 0.34% |
| JACKI M BARTHELEMY3 Filed as: JACKI M. BARTHELEMY | 7573 HILLTON ROAD ROYALTON, MN 56373 | UNION SECURITY INSURANCE COMPANY | $264 | $0 | $264 | 0.34% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE M. BARTHELEMY | 7573 HILLTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $2K | $8K | 10.93% |
| ASHLEY MARIA BARTHELEMY3 | 4011 BRADDOCK AVENUE NE BUFFALO, MN 55313 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $407 | $2K | 3.32% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $472 | $2K | 2.10% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH M. LANGEVIN AND AGENTS | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $285 | $1K | 2.03% |
| JEFFREY MICHAEL OURADNIK3 | 4203 PARKWAY DRIVE NISSWA, MN 56468 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $955 | $34 | $989 | 1.36% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $383 | $184 | $567 | 0.78% |
| ADVISORNET FINANCIAL, INC.3 | 701 4TH AVENUE SOUTH MINNEAPOLIS, MN 55415 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $497 | $0 | $497 | 0.69% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $977 | $0 | $977 | 13.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES, INC. | PO BOX 346 AVON, MN 56310 | SUN LIFE ASSURANCE COMPANY OF CANADA | $91 | $0 | $91 | 1.28% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE M. BARTHELEMY | 7573 HILLTON ROAD ROYALTON, MN 56373 | SUN LIFE ASSURANCE COMPANY OF CANADA | $91 | $0 | $91 | 1.28% |
| BENE USA LLC3 Filed as: BENE USA, LLC | 1851 LAKE DRIVE WEST, SUITE 350 CHANHASSEN, MN 55317 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $61 | $61 | 0.86% |
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 | 238 | 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) | 238 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 176 | $1.4M |
| Dental | UNION SECURITY INSURANCE COMPANY | 104 | $77K |
| Vision | UNION SECURITY INSURANCE COMPANY | 104 | $77K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 238 | $7K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 238 | $7K |
| Prescription drug | MEDICA INSURANCE COMPANY | 176 | $1.4M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 238 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 238 | — |
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.
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.