| 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 | $3K | $11K | 16.36% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1 | $1K | 2.25% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $912 | $163 | $1K | 1.88% |
| JORDAN SCOTT LEHTOLA3 | 1609 BENSON ROAD MONTEVIDEO, MN 56265 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $647 | $19 | $666 | 1.17% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $557 | $88 | $645 | 1.13% |
| MJ INSURANCE3 Filed as: JILL R. LAMBERT AND VARIOUS AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $198 | $54 | $252 | 0.44% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $193 | $15 | $208 | 0.36% |
| LEADER AGENCY LLC3 | 8140 HENRY AVENUE ALEXANDRIA, MN 56308 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $113 | $6 | $119 | 0.21% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $64K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $64K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $64K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 112 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.