| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 4300 MARKETPOINTE DRIVE, SUITE 600 BLOOMINGTON, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 6.27% |
| WELLS FARGO INSURANCE SERVICES3 | 400 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 1.75% |
| WELLS FARGO INSURANCE SERVICES3 | 400 HIGHWAY 169 SOUTH, SUITE 800 MINNEAPOLIS, MN 55426 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 7.27% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $567 | — | $567 | 2.06% |
| EDWARD D SOMMER3 Filed as: EDWARD CHRIS ROSENLUND | 8672 MEADOWVALE DRIVE EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $380 | — | $380 | 1.38% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LAROENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $199 | — | $199 | 0.72% |
| MEGAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $135 | — | $135 | 0.49% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DRIVE SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $98 | — | $98 | 0.36% |
| TAMMY M DAHLBERG3 Filed as: TAMMY M. DAHLBERG | 1009 EIGHTH AVENUE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $89 | — | $89 | 0.32% |
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 | 370 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 373 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $150K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $150K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $150K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 451 | $178K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 451 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.