| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $41K | $5K | $47K | 2.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $60 | $3K | 4.03% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $79 | $2K | 3.01% |
| ASHLEY MARIA HOUTMAN3 | 5447 BREEZY ROAD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $209 | $2K | 2.67% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $921 | $307 | $1K | 1.61% |
| MARIE DEENEY BELL AND OTHER AGENTS3 | PO BOX 1853 MINNETONKA, MN 55345 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $687 | $42 | $729 | 0.96% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DRIVE RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $329 | $14 | $343 | 0.45% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $292 | $24 | $316 | 0.42% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $6K | $0 | $6K | 7.89% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | — | $1K | $1K | 1.63% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | $0 | $4K | 7.91% |
| USI INSURANCE SERVICES LLC3 | 3805 WEST CHESTER PIKE, SUITE 200 NEWTOWN SQUARE, PA 19073 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $1K | $1K | 2.53% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 16.04% |
| USI INSURANCE SERVICES LLC3 | 3805 WEST CHESTER PIKE, SUITE 200 NEWTON SQUARE, PA 19073 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $537 | $537 | 3.12% |
| USI INSURANCE SERVICES LLC3 | 8331 NORMAN CENTER DRIVE, SUITE 500 MINNEAPOLIS, MN 55413 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $927 | $0 | $927 | 10.01% |
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 | 263 | 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) | 263 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 200 | $2.1M |
| Dental(2 contracts) | SUN LIFE ASSURANCE COMPANY OF CANADA | 108 | $124K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 121 | $9K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 289 | $17K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 289 | $17K |
| Prescription drug(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 200 | $2.1M |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 289 | $93K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 289 | — |
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."
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.