| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | PO BOX 2158 MARK S LERMAN RIVERSIDE, CA 92516 | MEDICA INSURANCE COMPANY | $16K | — | $16K | 2.99% |
| OCI INSURANCE AND FINANCIAL SERVICE3 | 4221 NORTH 203RD STREET SUITE 200 ELKHORN, NE 68022 | MEDICA INSURANCE COMPANY | $3K | — | $3K | 0.50% |
| OCI INSURANCE AND FINANCIAL SERVICE3 | 4221 NORTH 203RD STREET SUITE 200 ELKHORN, NE 68022 | MEDICA INSURANCE COMPANY | $2K | — | $2K | 0.38% |
| ZACHARY M SWARTZENDRUBER3 | 14128 BARIUM STREET NORTHWEST ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $810 | $108 | $918 | 3.11% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | 245 EAST ROSELAWN AVENUE ST PAUL, MN 55117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $646 | $3 | $649 | 2.20% |
| DEBORAH A ERICKSON3 | 4308 TWIN OAK LANE ROBBINSDALE, MN 55422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $259 | — | $259 | 0.88% |
| NATALIE SUZANNE FONVILLE3 | 1600 THOMAS AVENUE NORTH MINNEAPOLIS, MN 55411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $155 | $18 | $173 | 0.59% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $15 | $132 | 0.45% |
| JENNIFER STEINBAUGH3 | 4182 RUNNING BROOK ROAD EAGAN, MN 55122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.18% |
| LACIE M SWARTZENDRUBER3 | 2211 151ST AVENUE NORTHWEST ANDOVER, MN 55304 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.16% |
| TERI L SWARTZENDRUBER3 | 1805 5TH AVENUE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | — | $38 | 0.13% |
| JON SCOTT SWARTZENDRUBER3 | 1805 5TH AVENUE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | — | $35 | 0.12% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTRNTL MOUNTAIN STATES LTD | 520 MAIN AVENUE SUITE 800 FARGO, ND 58103 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON 12TH FLOOR CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $567 | $567 | 2.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | 245 ROSELAWN AVENUE EAST SUITE 31 SAINT PAUL, MN 55117 | DELTA DENTAL OF MINNESOTA | $2K | — | $2K | 9.36% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTRNTL MOUNTAIN STATES LTD | 520 MAIN AVENUE SUITE 800 FARGO, ND 58103 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 20.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MIDWEST LTD | 55 EAST JACKSON 12TH FLOOR CHICAGO, IL 60604 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $112 | $112 | 2.17% |
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 | 103 | 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) | 103 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 5 | $527K |
| Dental | DELTA DENTAL OF MINNESOTA | 36 | $24K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 103 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 103 | $27K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 103 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 103 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.