| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $2K | $9K | 14.81% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $8 | $2K | 4.34% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $676 | $2K | 3.64% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $866 | $287 | $1K | 2.16% |
| JORDON SCOTT LEHTOLA3 | 1609 BENSON ROAD MONTEVIDEO, MN 56265 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $885 | $94 | $979 | 1.84% |
| MJ INSURANCE3 Filed as: JILL R. LAMBERT AND VARIOUS AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $472 | $151 | $623 | 1.17% |
| ATB INSURANCE INC3 Filed as: ATB INSURANCE, INC. | 8654 SOUTH MAPLEBROOK CIRCLE BROOKLYN PARK, MN 55445 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $340 | $35 | $375 | 0.70% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $257 | $42 | $299 | 0.56% |
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 | 117 | 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) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $59K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $59K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $59K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 117 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.