| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | MEDICA INSURANCE COMPANY | $18K | $483 | $19K | 2.05% |
| JORDAN SCOTT LEHTOLA3 | 1609 BENSON ROAD MONTEVIDEO, MN 56265 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 7.49% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $150 | $4K | 7.44% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $978 | $3K | 5.18% |
| 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 | $279 | $2K | 2.92% |
| PEGGY SUE LAZER3 | 30585 OLSON STREET PEQUOTE LAKES, MN 56472 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $914 | $0 | $914 | 1.64% |
| DANIEL S SNIDER3 Filed as: DANIEL S. SNIDER | 303 22ND AVENUE WEST ALEXANDRIA, MN 56308 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $366 | $396 | $762 | 1.37% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $348 | $147 | $495 | 0.89% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | UNION SECURITY INSURANCE COMPANY | $4K | $343 | $5K | 10.82% |
| USI INSURANCE SERVICES LLC3 | 15350 25TH AVENUE NORTH, SUITE 114 PLYMOUTH, MN 55447 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | $0 | $3K | 13.08% |
| MGIS3 | 111 SOUTH MAIN STREET, SUITE 400 SALT LAKE CITY, UT 84111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $293 | $180 | $473 | 2.19% |
| USI INSURANCE SERVICES LLC3 | 1020 36TH STREET SOUTH FARGO, ND 58103 | FIDELITY LIFE INSURANCE COMPANY | $459 | $0 | $459 | 10.00% |
| DIRECT BENEFITS INC3 Filed as: DIRECT BENEFITS, INC. | 325 CEDAR STREET, SUITE 800 SAINT PAUL, MN 55101 | FIDELITY LIFE INSURANCE COMPANY | $367 | $0 | $367 | 8.00% |
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 | 114 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 94 | $902K |
| Dental | UNION SECURITY INSURANCE COMPANY | 71 | $42K |
| Vision | FIDELITY LIFE INSURANCE COMPANY | 75 | $5K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 114 | $22K |
| Prescription drug | MEDICA INSURANCE COMPANY | 94 | $902K |
| Other(3 contracts, 3 carriers) | MEDICA INSURANCE COMPANY | 114 | $979K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.