| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ENROLLEASE3 Filed as: HANRATTY AND ASSOCIATES INC | 15350 25TH AVENUE N SUITE 114 PLYMOUTH, MN 55447 | BCBSM D.B.A. BLUE CROSS BLUE SHIELD OF MINNESOTA | $9K | — | $9K | 2.49% |
| CANOPY GROUP INC3 Filed as: THE CANOPY GROUP | PO BOX 175 LE SUER, MN 56058 | BCBSM D.B.A. BLUE CROSS BLUE SHIELD OF MINNESOTA | $2K | $1K | $3K | 0.75% |
| ENROLLEASE3 Filed as: HANRATTY & ASSOCIATES | 15350 25TH AVENUE N SUITE 114 PLYMOUTH, MN 55447 | UNION SECURITY INSURANCE COMPANY | $1K | $66 | $1K | 2.24% |
| ENROLLEASE3 Filed as: HANRATTY & ASSOCIATES INC | 15350 25TH AVENUE N SUITE 114 PLYMOUTH, MN 55447 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| CANOPY GROUP INC3 | PO BOX 175 LE SUER, MN 56058 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 9.78% |
| ENROLLEASE3 Filed as: HANRATTY & ASSOCIATES INC | 15350 25TH AVENUE N SUITE 114 PLYMOUTH, MN 55447 | UNION SECURITY INSURANCE COMPANY | $602 | — | $602 | 3.29% |
| ENROLLEASE3 Filed as: HANRATTY & ASSOCIATES INC | 15350 25TH AVENUE N SUITE 114 PLYMOUTH, MN 55447 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $767 | — | $767 | 15.55% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSM INC OF MN EIN 41-0984460 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $63K |
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 NONE | Claims processing; Insurance agents and brokers; Non-monetary compensation; Other fees; Other commissions 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 | 132 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSM D.B.A. BLUE CROSS BLUE SHIELD OF MINNESOTA | 124 | $375K |
| Dental | UNION SECURITY INSURANCE COMPANY | 45 | $60K |
| Vision(2 contracts, 2 carriers) | UNION SECURITY INSURANCE COMPANY | 113 | $23K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $52K |
| Long-term disability(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $52K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 132 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.