| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JUDITH LINDSTROM | 9060 BRENTWOOD TRAIL WOODBURY, MN 55125 | BLUECROSS AND BLUESHIELD OF MINNESOTA | $165 | — | $165 | 4.16% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF MN EIN 41-0984460 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Direct payment from the plan; Contract Administrator Service code 12 | — | $2.5M |
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $873K |
| DELTA DENTAL EIN 41-1905554 NONE | Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $251K |
| UNITED ACTUARIAL SERVICES, INC. EIN 35-2156428 NONE | Actuarial; Direct payment from the plan Service code 11 | — | $104K |
| ANDREW, BRANSKY, & POOLE EIN 41-1502219 NONE | Legal Service code 29 | — | $70K |
| UNION BANK AND TRUST EIN 41-1267434 NONE | Custodial (securities); Direct payment from the plan Service code 19 | — | $66K |
| BARLOW COUGHRAN MORALES & JOSEPHSON EIN 91-0889948 NONE | Legal; Direct payment from the plan Service code 29 | — | $66K |
| PRIME THERAPEUTICS LLC EIN 26-0076803 NONE | Claims processing; Float revenue; Direct payment from the plan; Other services Service code 12 | — | $59K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Claims processing Service code 12 | — | $53K |
| MCCORMICK LAW OFFICE, PA EIN 41-1854245 NONE | Legal; Direct payment from the plan Service code 29 | — | $47K |
| NATIONAL INVESTMENT SERVICES, LLC EIN 84-3937993 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $36K |
| MILLER KAPLAN ARASE LLP EIN 95-2036255 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $35K |
| ST CROIX PRESS, INC. NONE | Copying and duplicating; Direct payment from the plan Service code 36 | 1185 S KNOWLES AVE NEW RICHMOND, WI 54017 | $22K |
| EPLAN, LLC EIN 20-3720767 NONE | Consulting (general) Service code 16 | — | $19K |
| MARQUETTE ASSOCIATES EIN 36-3485298 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $16K |
| HONSA-BINDER PRINTING, INC EIN 41-1605232 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $9K |
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 | 3,287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 293 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,580 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS AND BLUESHIELD OF MINNESOTA | 2 | $4K |
| Prescription drug | BLUECROSS AND BLUESHIELD OF MINNESOTA | 109 | $206K |
| Stop-loss / reinsurancereinsurance | BLUECROSS AND BLUESHIELD OF MINNESOTA | 0 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.