| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $22K | $2K | $24K | 11.62% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $907 | $907 | 0.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.62% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $1 | $0 | $1 | 0.00% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MW, INC. | 1600 UTICA AVENUE SOUTH MINNEAPOLIS, MN 55416 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $0 | $1K | 5.15% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $796 | $447 | $1K | 5.09% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH M. LANGEVIN AND AGENTS | 698 WEST LARPENTEUR AVENUE ST. PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $786 | $123 | $909 | 3.72% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $686 | — | $686 | 2.81% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE, INC. | 6505 DEMPSEY AVENUE SW WAVERLY, MN 55390 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $438 | $104 | $542 | 2.22% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $452 | $2 | $454 | 1.86% |
| ATB INSURANCE INC3 Filed as: ATB INSURANCE, INC. | 8654 SOUTH MAPLEBROOK CIRCLE BROOKLYN PARK, MN 55445 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $243 | $25 | $268 | 1.10% |
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 | 159 | 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) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 374 | $53K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $206K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 44 | $24K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $206K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 159 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.