| 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 | $51K | — | $51K | 11.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60008 | HARTFORD LIFE AND ACCIDENT | — | $20K | $20K | 4.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | — | BCBSMN, INC, D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $90K | $13K | $102K | 23.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | TWO PIERCE PL, 21ST FL ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $40K | — | $40K | 17.50% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SVCS INC | 2850 W GOLF RD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $6K | $6K | 2.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF MINN. EIN 41-0984460 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees; Contract Administrator Service code 12 | — | $816K |
| FURTHER EIN 41-0715583 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $37K |
| TOTAL ADMINISTRATIVE SERVICES CORP EIN 39-1561025 NONE | Contract Administrator Service code 13 | 2302 INTERNATIONAL LANE MADISON, WI 53704 | $31K |
| SAND CREEK EAP LLC EIN 41-1776423 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $28K |
| WILLIS TOWERS WATSON EIN 53-0181291 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $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 | 1,679 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 83 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,762 | 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 | 2,497 | $570K |
| Dental | DDMN ASO, LLC | 3,277 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,679 | $679K |
| Stop-loss / reinsurancereinsurance | HEALTHPARTNERS ADMINISTRATORS, INC. | 594 | $126K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,679 | $679K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,277 | — |
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."
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.