| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 7225 NORTHLAND DR N STE 300 MINNEAPOLIS, MN 55428 | UNION SECURITY INSURANCE COMPANY | $20K | — | $20K | 9.99% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RJF AGENCIES INC | 7225 NORTHLAND DR N STE 300 MINNEAPOLIS, MN 55428 | UNION SECURITY INSURANCE COMPANY | — | $5K | $5K | 2.43% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH AND MCLENNAN AGENCY LLC | 7225 NORTHLAND DR N STE 300 MINNEAPOLIS, MN 55428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | $4K | $17K | 15.39% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RJF A MARSH AND MCLENNAN AGENCY LLC | 7225 NORTHLAND DR N STE 300 MINNEAPOLIS, MN 55428 | EYEMED | $3K | — | $3K | 9.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MIKE MULDER EIN 47-6522568 TRUSTEE | Trustee (directed) Service code 25 | 408 6TH ST PRINSBURG, MN 56281 | $6K |
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 | 549 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 551 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | UNION SECURITY INSURANCE COMPANY | 239 | $200K |
| Vision | EYEMED | 527 | $33K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $112K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $112K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $112K |
| Stop-loss / reinsurancereinsurance | HEALTHPARTNERS ADMINISTRATORS INC | 0 | $640K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 527 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.