| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8331 NORMAN CENTER DRIVE SUITE 500 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $44K | $0 | $44K | 2.66% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 8331 NORMAN CENTER DRIVE SUITE 500 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $14K | $0 | $14K | 0.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH FLOOR 8 SAINT LOUIS PARK, MN 55426 | MEDICA INSURANCE COMPANY | $0 | $2K | $2K | 0.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH SUITE 800 SAINT LOUIS PARK, MN 55426 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $57 | $15K | 15.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.93% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 15350 25TH AVENUE NORTH PLYMOUTH, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $709 | $4 | $713 | 4.21% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $387 | $4 | $391 | 2.31% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $172 | $4 | $176 | 1.04% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE ROAD FRAZEE, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $153 | $0 | $153 | 0.90% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 1401 5TH AVENUE SOUTHEAST APARTMENT 102 LITTLE FALLS, MN 56345 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.41% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN MOFFATT LUCAS & VARIOUS AGEN | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | $4 | $26 | 0.15% |
| ARLO I MATHISON3 | 28118 141ST STREET NORTHWEST ZIMMERMAN, MN 55398 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.12% |
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 | 233 | 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) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 236 | $1.7M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 233 | $100K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 233 | $100K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 233 | $100K |
| Prescription drug | MEDICA INSURANCE COMPANY | 236 | $1.7M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 233 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.