| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 4300 MARKET POINTE DRIVE SUITE 600 BLOOMINGTON, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $0 | $10K | 6.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 400 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $3K | $3K | 1.75% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH SUITE 800 MINNEAPOLIS, MN 55426 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 6.89% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $468 | $40 | $508 | 2.04% |
| ROSE MARY GOODMAN3 | 5200 HOLLY LANE NORTH #4 PLYMOUTH, MN 55446 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $352 | $30 | $382 | 1.53% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $179 | $11 | $190 | 0.76% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $149 | $17 | $166 | 0.66% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DRIVE SOUTHEAST SAINT MICHAEL, MN 55376 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $83 | $0 | $83 | 0.33% |
| MJ INSURANCE3 Filed as: MICHELLE J HALLER & VARIOUS AGENTS | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $17 | $77 | 0.31% |
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 | 481 | 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) | 481 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 481 | $159K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 481 | $159K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 481 | $159K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 481 | $184K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 481 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.