| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | PREFERREDONE INSURANCE COMPANY | $26K | — | $26K | 1.99% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | $3K | $20K | 17.22% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR, STE 400 BLOOMINGTON, MN 55437 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $158 | $4K | 8.56% |
| MARC A GROVE0 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 7.12% |
| DANIELLE BROOK KUECHLE0 | 114 RAMBLING CREEK DR SE SAINT MICHALE, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $619 | — | $619 | 1.20% |
| ELIZABETH MARIE LANGEVIN0 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $405 | $87 | $492 | 0.95% |
| MEGHAN MOFFATT LUCAS0 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $297 | $147 | $444 | 0.86% |
| AUSTIN BOHLER0 | 15861 60TH AVE N PLYMOUTH, MN 55446 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $387 | — | $387 | 0.75% |
| PAUL KUKLOCK0 | 839 KAYLA LN NE HANOVER, MN 55341 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $305 | — | $305 | 0.59% |
| JILL R LAMBERT0 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $140 | $63 | $203 | 0.39% |
| TR INSURANCE ADVISORS INC0 Filed as: TR INSURANCE ADVISORS | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $176 | $18 | $194 | 0.37% |
| ANDREW JAMIN GRIMSLEY0 | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | $15 | $137 | 0.26% |
| SMARTER HSA LLC0 | 3963 COTTAGE LANE MINNETONKA, MN 55305 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | — | $122 | 0.24% |
| DESIREE WENDELL0 | 40771 FENIAN WAY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $113 | — | $113 | 0.22% |
| TERRI KAYE0 | 4320 43RD AVE S MINNEAPOLIS, MN 55406 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.21% |
| MICHELLE J HALLER0 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | $50 | $103 | 0.20% |
| JON OLSON0 | 5650 W 36TH ST APT 509 ST LOUIS PARK, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $1 | $101 | 0.20% |
| ELIZABETH C OVERBO0 Filed as: ELIZABETH COVERBO | 9725 PLEASANT AVE S BLOOMINGTON, MN 55420 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.18% |
| CARRIE S FLATEN0 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $54 | $15 | $69 | 0.13% |
| NELS COREY JOHNSON0 | 25262 SLOTH ST NW ZIMMERMAN, MN 55398 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | — | $59 | 0.11% |
| CAROLYN GROVER0 | 206 FOX CHAPEL DR IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $3 | $53 | 0.10% |
| WORLD INSURANCE ASSOCIATES LLC0 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $45 | $8 | $53 | 0.10% |
| JENNIFER B WILLIAMS0 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $1 | $51 | 0.10% |
| JOHN CHARLES CHERRY0 | 120 7TH ST W HASTINGS, MN 55033 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.07% |
| ATB INSURANCE INC0 Filed as: ATB INSURANCE INC. | 15861 60TH AVENUE N PLYMOUTH, MN 55446 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | $9 | $29 | 0.06% |
| CAROL BARNES0 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $2 | $17 | 0.03% |
| NORTH FLORIDA BENEFIT SOLUTIONS INC0 | 12659-1 PLUMMER GRAND RD JACKSONVILLE, FL 32258 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| SHEALY BENEFITS SERVICES INC0 Filed as: SHEALY BENEFITS SERVICES INC. | 215 HOGAN WAY LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $3 | $7 | 0.01% |
| JENNIFER GROVE0 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| ADVANCED BENEFIT SYSTEM INC0 Filed as: ADVANCED BENEFIT SYSTEMS | 245 SEVEN FARMS DRIVE DANIEL ISLAND, SC 29492 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $3 | $5 | 0.01% |
| CRAIG WAYNE SOTTILE3 | 408 CEDAR PINES DRIVE GREENVILLE, SC 29615 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $1 | $5 | 0.01% |
| CLARICE R MIMS0 | 172-90 HIGHLAND AVE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.01% |
| SANDRA SIMS0 | 13750 W COLONIAL DR STE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| BRAD BIEL0 | 1050 WALL ST W LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $2 | $3 | 0.01% |
| ANDREW CHARLES FELLS0 Filed as: ANDREW CHARLES FELL | 331 WEST HUMPHREY ST LAKE CRYSTAL, MN 56055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| KLD INSURANCE BENEFITS INC0 Filed as: KLD INSURANCE BENEFITS INC. | 9085 BETHEL RD GAINSVILLE, GA 30506 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| WILLIAM RENNARD0 | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| NORWOOD BENEFIT SERVICES INC0 Filed as: NORWOOD BENEFIT SERVICES INC. | 6478 LONG BREEZE RD ORLANDO, FL 32810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| LAURA B WETT0 | 8194 HYDE AVE S COTTAGE GROVE, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | — | $1K | 15.67% |
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 | 208 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREFERREDONE INSURANCE COMPANY | 254 | $1.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 149 | $8K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 229 | $113K |
| Short-term disability(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 229 | $165K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 229 | $113K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 229 | $165K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 254 | — |
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.