| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELIABLE AGENCY, INC.3 | 803 CARLTON AVENUE CLOQUET, MN 55720 | DELTA DENTAL OF MINNESOTA | $20K | $0 | $20K | 9.58% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | STANDARD INSURANCE COMPANY | $38K | $0 | $38K | 32.94% |
| BENEFIT BUILDERS & ASSOCIATES INC.3 Filed as: BENEFIT BUILDERS & ASSOCIATES, INC. | 7777 WASHINGTON VILLAGE DRIVE SUITE 170 DAYTON, OH 45459 | STANDARD INSURANCE COMPANY | $34 | $0 | $34 | 0.03% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $211 | $4K | 6.67% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | UNKNOWN CRANSTON, RI 02920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 4.28% |
| JACQUELINE BARTHELEMY3 | 7573 HILLTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $87 | $2K | 3.98% |
| ASHLEY MARIA HOUTMAN3 | 5447 BREEZY ROAD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $118 | $2K | 3.94% |
| ELIZABTH LANGEVIN AND OTHER AGENTS3 | 51685 BELLE ISLE DRIVE RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $262 | $0 | $262 | 0.45% |
| CARRIE S FLATEN3 Filed as: CARRIE S. FLATEN | 2702 86TH COURT WEST NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $160 | $0 | $160 | 0.27% |
| ACRISURE LLC3 | UNKNOWN DULUTH, MN 49316 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $138 | $0 | $138 | 0.23% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | FIDELITY SECURITY LIFE | $2K | $0 | $2K | 10.00% |
| RELIABLE AGENCY, INC.4 | PO BOX 620 CLOQUET, MN 55720 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $494 | $0 | $494 | 9.35% |
| DAVID J. KLEINSMITH4 | PO BOX 610 MAPLE HILL, KS 66507 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $60 | $0 | $60 | 1.14% |
| KCA MARKETING INC DBA LEGAL BENEFIT4 Filed as: KCA MARKETING, INC. | PO BOX 1702 MAPLE GROVE, MN 55311 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $29 | $0 | $29 | 0.55% |
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 | 403 | 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) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 498 | $210K |
| Vision | FIDELITY SECURITY LIFE | 276 | $18K |
| Life insurance | STANDARD INSURANCE COMPANY | 403 | $115K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 84 | $59K |
| Long-term disability | STANDARD INSURANCE COMPANY | 403 | $115K |
| Other(3 contracts, 3 carriers) | STANDARD INSURANCE COMPANY | 403 | $179K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 498 | — |
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.