| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 3600 AMERICAN BLVD STE 500 BLOOMINGTON, MN 55431 | HARTFORD LIFE AND ACCIDENT | $91K | — | $91K | 10.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2 PIERCE PLACE 21ST FL ITASCA, IL 601433141 | HARTFORD LIFE AND ACCIDENT | — | $14K | $14K | 1.70% |
| WILLIS TOWERS WATSON US LLC3 | — | BCBSMN, INC, D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $110K | $10K | $120K | 27.25% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX 28852 PO BOX 28852 NEW YORK, NY 10087 | HEALTHPARTNERS ADMINISTRATORS, INC. | $20K | — | $20K | 6.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF MINN. EIN 41-0984460 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Claims processing; Insurance brokerage commissions and fees; Contract Administrator; Legal; Other commissions; Insurance agents and brokers Service code 12 | — | $872K |
| TOWERS WATSON DELEWARE INC. EIN 53-0181291 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $190K |
| ADVANCED MEDICAL NONE | Direct payment from the plan; Contract Administrator Service code 13 | 4525 HEDGEMORE DRIVE CHARLOTTE, NC 28209 | $106K |
| ASH COMPANIES HEALTHYROADS, INC. NONE | Other services; Direct payment from the plan; Consulting (general) Service code 16 | P.O. BOX 509040 SAN DIEGO, CA 921509040 | $55K |
| TOTAL ADMINISTRATIVE SERVICES CORP EIN 39-1561025 NONE | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $35K |
| FURTHER EIN 41-0715583 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $32K |
| THE SAND CREEK GROUP, LTD EIN 41-1776423 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $31K |
| TELADOC NONE | Direct payment from the plan; Other fees Service code 50 | 4100 SPRING VALLEY SUITE 515 DALLAS, TX 75244 | $25K |
| SIMPLE BENEFIT PLAN ADMIN, LLC EIN 45-5118723 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $5K |
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 | 1,781 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 90 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,871 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BCBSMN, INC, D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 2,870 | $753K |
| Dental | DDMN ASO, LLC | 3,644 | $1.4M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 1,781 | $839K |
| Stop-loss / reinsurancereinsurance | HEALTHPARTNERS ADMINISTRATORS, INC. | 593 | $313K |
| Other | HARTFORD LIFE AND ACCIDENT | 1,781 | $839K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,644 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.