| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY4 Filed as: THE SEGAL COMPANY (MIDWEST), INC. | 3800 AMERICAN BLVD W, STE 870 BLOOMINGTON, MN 554314459 | BCBSM, INC. DBA BLUE CROSS BLUE SHIELD OF MINNESOTA | — | $22K | $22K | 3.68% |
| CAPITOL SPECIAL RISKS3 | 1899 POWERS FERRY ROAD ATLANTA, GA 30339 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $12K | — | $12K | 15.00% |
| INTERACTIVE INSURANCE SOLUTIONS3 | 729 RAGSDALE ROAD SHARPSBURG, GA 30277 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Accounting (including auditing); Contract Administrator Service code 10 | — | $1.1M |
| BLUE CROSS BLUE SHIELD OF MN EIN 41-0984460 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Other fees; Contract Administrator Service code 12 | — | $847K |
| KUTAK ROCK LLP EIN 47-0597598 NONE | Legal Service code 29 | — | $115K |
| DDMN ASO, LLC EIN 41-1905554 NONE | Claims processing Service code 12 | — | $109K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Consulting (general) Service code 16 | — | $58K |
| NATIONAL INVESTMENT SERVICES OF AME EIN 84-3937993 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $52K |
| TEAM, INC. EIN 81-4050818 NONE | Claims processing Service code 12 | — | $46K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $32K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $25K |
| ANCHOR CAPITAL ADVISORS LLC EIN 20-4669888 NONE | Securities brokerage commissions and fees; Investment management; Soft dollars commissions; Investment management fees paid directly by plan Service code 28 | — | $10K |
| BMO HARRIS EIN 36-2085229 NONE | Custodial (securities); Other services Service code 19 | — | $7K |
| PRIME THERAPEUTICS EIN 26-0076803 NONE | Other services; Other fees; Claims processing; Float revenue Service code 12 | — | $6K |
| HONSA-BINDER PRINTING INC. EIN 41-1605232 NONE | Copying and duplicating Service code 36 | — | $5K |
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 | 3,453 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 109 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,562 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 138 | $333K |
| Life insurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 3,561 | $82K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 136 | $253K |
| Stop-loss / reinsurancereinsurance | BCBSM, INC. DBA BLUE CROSS BLUE SHIELD OF MINNESOTA | 3,484 | $593K |
| Other(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 4,297 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,297 | — |
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.