| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 6100 GOLDEN HILLS DRIVE GOLDEN VALLEY, MN 55416 | MEDICA INSURANCE COMPANY | $37K | $3K | $40K | 3.43% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RJF, MARSH & MCLENNAN AGENCY LLC | 7225 NORTHLAND DRIVE N #300 MINNEAPOLIS, MN 55428 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 9.13% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICA SELF-INSURED EIN 41-1479417 CLAIM PROCESSING | Float revenue; Contract Administrator; Claims processing Service code 12 | — | $524K |
| DDMN ASO LLC EIN 41-1852523 BENEFIT ADMIN | Contract Administrator; Claims processing Service code 12 | — | $32K |
| MARSH & MCLENNAN AGENCY LLC AGENT | Insurance agents and brokers Service code 22 | 6160 GOLDEN HILLS DRIVE MINNEAPOLIS, MN 55416 | $3K |
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 | 512 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 514 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 870 | $55K |
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 993 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 993 | — |
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.