| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC | 200 GALLERIA PKWY 1950 ATLANTA, GA 30339 | BCBSMN, INC. DBA BLUE CROSS AND BLUE SHIELD MINNESOTA | $1K | — | $1K | 1.44% |
| FIDUCIA BENEFITS GROUP INC3 Filed as: FIDUCIA BENEFITS GROUP INC. | 517 NW FOURTH STREET BRAINERD, MN 56401 | BCBSMN, INC. DBA BLUE CROSS AND BLUE SHIELD MINNESOTA | $345 | — | $345 | 0.46% |
| DIGITAL INSURANCE LLC | 200 GALLERIA PARKWAY STE 1950 ATLANTA, GA 30339 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 10.05% |
| FIDUCIA BENEFITS GROUP INC3 | 517 NW 4TH ST BRAINERD, MN 56401 | STANDARD INSURANCE COMPANY | $827 | — | $827 | 1.69% |
| FIDUCIA BENEFITS GROUP INC3 Filed as: FIDUCIA BENEFITS GROUP | 517 NW 4TH STREET BRAINERD, MN 56401 | BCBSMN, INC. DBA BLUE CROSS AND BLUE SHIELD MINNESOTA | $207K | $5K | $212K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN, INC. DBA BLUE CROSS AND BLU EIN 41-0984460 CONTRAC ADMINISTRATOR | Other fees; Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | PO BOX 64668 ST. PAUL, MN 55164 | $641K |
| SMITH HEALTH, INC. CONTRACT ADMIN | Contract Administrator; Claims processing Service code 12 | 300 BRANNAN STRET STE 601 SAN FRANCISCO, CA 94107 | $109K |
| WESTBERG EISCHENS, PLLP EIN 41-1792388 ACCOUNTING - AUDITING | Accounting (including auditing) Service code 10 | 2630 1ST ST S WILLMAR, MN 56201 | $80K |
| FIDUCIA BENEFITS GROUP EIN 20-0257666 CONTRACT ADMIN | Contract Administrator Service code 13 | 517 NW 4TH STREET BRAINERD, MN 56401 | $27K |
| PRUCO SECURITIES, LLC EIN 23-2384840 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | PO BOX 15070 NEW BRUNSWICK, NJ 089065070 | $25K |
| RBA EIN 20-4004667 COMPUTER CONSULTING | Other services Service code 49 | 294 GROVE LANE E, STE 100 WAYZATA, MN 55391 | $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 | 1,093 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSMN, INC. DBA BLUE CROSS AND BLUE SHIELD MINNESOTA | 25 | $75K |
| Life insurance | STANDARD INSURANCE COMPANY | 431 | $49K |
| Stop-loss / reinsurancereinsurance | BCBSMN, INC. DBA BLUE CROSS AND BLUE SHIELD MINNESOTA | 2,082 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,082 | — |
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.