| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS AGENCY | 700 IDS CENTER 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $32K | $2K | $33K | 3.22% |
| JEFFREY A. FOSTER3 | 940 BROWN RDS WAYZATA, MN 55391 | GUARDIAN INSURANCE COMPANY | $4K | — | $4K | 3.14% |
| TIMOTHY D. FOSTER3 | P.O. BOX 821 221 MANITOBA AVENUE SOUTH WAYZATA, MN 55391 | GUARDIAN INSURANCE COMPANY | $4K | — | $4K | 3.14% |
| BRUCE R BREMER3 Filed as: BRUCE R.BREMER | 901 MARQUETTE AVENUE SUITE 2600 MINNEAPOLIS, MN 55402 | DELTA DENTAL | $5K | — | $5K | 6.90% |
| DIRECT BENEFITS INC Filed as: DIRECT BENEFITS | 325 CEDAR STREET, #800 ST. PAUL, MN 55101 | DELTA DENTAL | $2K | — | $2K | 3.45% |
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 | 149 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 149 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 93 | $1.0M |
| Dental | DELTA DENTAL | 97 | $72K |
| Life insurance | GUARDIAN INSURANCE COMPANY | 145 | $130K |
| Other | GUARDIAN INSURANCE COMPANY | 145 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.