| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $64K | — | $64K | 2.50% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $3K | $27K | 17.00% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $8K | $8K | 5.00% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $460 | $4K | 17.00% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 5.00% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | EYEMED VISION CARE | $2K | — | $2K | 10.05% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $339 | $3K | 17.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DDMN ASO, LLC EIN 41-1852523 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $11K |
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 | 171 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 180 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 151 | $2.6M |
| Vision | EYEMED VISION CARE | 126 | $22K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $159K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $159K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $159K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 171 | $199K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.