| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 6100 GOLDEN HILLS DRIVE GOLDEN VALLEY, MN 55416 | MEDICA INSURANCE COMPANY | $47K | $3K | $50K | 3.82% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RJF, MARSH & MCLENNAN AGENCY LLC | 7225 NORTHLAND DRIVE N #300 MINNEAPOLIS, MN 55428 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $6K | — | $6K | 9.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICA SELF-INSURED EIN 41-1479417 CLAIM PROCESSING | Claims processing; Float revenue; Contract Administrator Service code 12 | — | $730K |
| DDMN ASO LLC EIN 41-1852523 BENEFIT ADMIN | Claims processing; Contract Administrator Service code 12 | — | $36K |
| 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 | 504 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 506 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 869 | $56K |
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 1,014 | $1.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,014 | — |
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.