| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $66K | $903 | $67K | 3.55% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | METROPOLITAN LIFE INSURANCE COMPANY | $28K | $60 | $28K | 14.39% |
| USI INSURANCE SERVICES LLC3 | 1018 WEST 9TH AVENUE, SUITE 100 KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.26% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCES SERVICES LLC | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $515 | $0 | $515 | 3.67% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $290 | $0 | $290 | 2.07% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $129 | $0 | $129 | 0.92% |
| MELISSA ARMATIS Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE ROAD FRAZEE, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $114 | $0 | $114 | 0.81% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.06% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.06% |
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 | 415 | 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) | 415 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 247 | $1.9M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $194K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $194K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $194K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $194K |
| Prescription drug | MEDICA INSURANCE COMPANY | 247 | $1.9M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 415 | $208K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 415 | — |
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.