| 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 | $20K | — | $20K | 2.99% |
| OCI INSURANCE AND FINANCIAL SERVICE3 | 4221 NORTH 203RD STREET SUITE 200 ELKHORN, NE 68022 | MEDICA INSURANCE COMPANY | -$2K | — | -$2K | -0.30% |
| OCI INSURANCE AND FINANCIAL SERVICE3 | 4221 NORTH 203RD STREET SUITE 200 ELKHORN, NE 68022 | MEDICA INSURANCE COMPANY | -$3K | — | -$3K | -0.40% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP--MARK LERMAN | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | DELTA DENTAL OF MINNESOTA | $2K | — | $2K | 4.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | 520 MAIN AVENUE SUITE 800 FARGO, ND 58103 | DELTA DENTAL OF MINNESOTA | $1K | — | $1K | 3.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | DELTA DENTAL OF MINNESOTA | $330 | — | $330 | 1.02% |
| ZACHARY M SWARTZENDRUBER3 | 14128 BARIUM STREET NORTHWEST ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $840 | $323 | $1K | 4.22% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | 245 EAST ROSELAWN AVENUE ST PAUL, MN 55117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $683 | — | $683 | 2.48% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | $8 | $142 | 0.51% |
| NATALIE SUZANNE FONVILLE3 | 1600 THOMAS AVENUE NORTH MINNEAPOLIS, MN 55411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | — | $137 | 0.50% |
| CARL WALLIN3 | 4750 TIMBER PARKWAY SOUTH APARTMENT 110 FARGO, ND 58104 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $130 | — | $130 | 0.47% |
| DEBORAH A ERICKSON3 | 4308 TWIN OAK LANE ROBBINSDALE, MN 55422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $122 | — | $122 | 0.44% |
| MAGGIE DUNCANSON3 | 4926 COUNTY ROAD 45 BRAINERD, MN 56401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | $70 | $97 | 0.35% |
| LACIE M SWARTZENDRUBER3 Filed as: LACIE SWARTZENDRUBER | 2211 151ST AVENUE NORTHWEST ANDOVER, MN 55304 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | — | $60 | 0.22% |
| TERI L SWARTZENDRUBER3 | 1805 5TH AVENUE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | $1 | $53 | 0.19% |
| TAYLOR MARIE SHERMAN3 | 2713 26TH AVENUE SOUTH FARGO, ND 58103 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $4 | $14 | 0.05% |
| JON SCOTT SWARTZENDRUBER3 | 1805 5TH AVENUE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.04% |
| 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 | $3K | — | $3K | 11.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DRIVE #100 OMAHA, NE 68154 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 8.02% |
| 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 | $607 | — | $607 | 11.77% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DRIVE #100 OMAHA, NE 68154 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $425 | — | $425 | 8.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP--MARK LERMAN | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | HEALTH VENTURES NETWORK | $116 | — | $116 | 3.87% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL MOUNTAIN STATES L | 520 MAIN AVENUE SUITE 800 FARGO, ND 58103 | HEALTH VENTURES NETWORK | $57 | — | $57 | 1.90% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS, LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | HEALTH VENTURES NETWORK | $41 | — | $41 | 1.37% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 59 | $662K |
| Dental | DELTA DENTAL OF MINNESOTA | 95 | $32K |
| Vision | HEALTH VENTURES NETWORK | 61 | $3K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 126 | $5K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 123 | $26K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 126 | $33K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.