| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSET LOOP SUITE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $256 | $256 | 1.05% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN && BROWN INS AGENCY OF VA | 11220 ASSET LOOP SUITE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $238 | $238 | 1.06% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSET LOOP SUITE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $313 | $313 | 3.41% |
| MICHELLE J HALLER3 Filed as: MICHELLE J. HALLER | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $124 | $0 | $124 | 2.41% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.52% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH LANGEVIN | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.52% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.52% |
| NATIONAL ENROLLMENT PARTNERS GENERA3 Filed as: NATIONAL ENROLLMENT PARTNER LLC | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.21% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80TH SOUTH 8TH STREET #700 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPA | $302 | — | $302 | 6.55% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SERVICES INC | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPA | $120 | — | $120 | 2.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA | 11220 ASSET LOOP SUITE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3 | $3 | 0.24% |
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 | 116 | 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) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE COMPA | 105 | $5K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $9K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 116 | $22K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 116 | $24K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 116 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.