| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BREMER INSURANCE AGENCIES INC.3 Filed as: BREMER INSURANCE AGENCIES, INC. | PO BOX 188 SOUTH SAINT PAUL, MN 550750188 | HARTFORD LIFE AND ACCIDENT | $58K | — | $58K | 8.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 3600 AMERICAN BLVD WEST SUITE 500 BLOOMINGTON, MN 55431 | HARTFORD LIFE AND ACCIDENT | $7K | — | $7K | 1.02% |
| WILLIS TOWERS WATSON US LLC3 Filed as: TOWERS WATSON, CONSULTANT | LOCKBOX 28852, PO BOX 28852 NEW YORK, NY 10087 | HEALTHPARTNERS ADMINISTRATORS, INC. | $18K | — | $18K | 6.95% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF MINN. EIN 41-0984460 NONE | Insurance agents and brokers; Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other fees; Claims processing; Insurance brokerage commissions and fees; Direct payment from the plan; Contract Administrator; Other commissions Service code 12 | — | $859K |
| HEALTHPARTNERS EIN 41-1693838 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $266K |
| TOWERS WATSON DELAWARE INC. EIN 53-0181291 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $142K |
| ADVANCED MEDICAL NONE | Contract Administrator; Direct payment from the plan Service code 13 | 4525 HEDGEMORE DRIVE CHARLOTTE, NC 28209 | $85K |
| DDMN ASO, LLC EIN 41-1905554 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $82K |
| ASH COMPANIES HEALTHYROADS, INC NONE | Consulting (general); Other services; Direct payment from the plan Service code 16 | P.O. BOX 509040 SAN DIEGO, CA 921509040 | $68K |
| TASC MEDSOFT/ACCLAIM EIN 39-1561025 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $38K |
| THE SAND CREEK GROUP, LTD. EIN 41-1776423 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $31K |
| SELECTACCOUNT EIN 41-0715583 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $26K |
| TELADOC INC. NONE | Other fees; Direct payment from the plan Service code 50 | 4100 SPRING VALLEY SUITE 515 DALLAS, TX 75244 | $25K |
| U.S. BANK NATIONAL ASSOCIATION EIN 31-0841368 NONE | Direct payment from the plan; Float revenue; Soft dollars commissions; Contract Administrator; Other fees; Trustee (bank, trust company, or similar financial institution) Service code 13 | — | $7K |
| SIMPLE BENEFIT PLAN ADMIN., LLC EIN 45-5118723 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $7K |
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 | 1,830 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 78 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,908 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHPARTNERS ADMINISTRATORS, INC. | 566 | $266K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,830 | $647K |
| Stop-loss / reinsurancereinsurance | HEALTHPARTNERS ADMINISTRATORS, INC. | 566 | $266K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,830 | $647K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,830 | — |
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.