| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 | 400 HIGHWAY 169 SOUTH 8TH FLOOR MINNEAPOLIS, MN 55426 | MEDICA INSURANCE COMPANY | $30K | $4K | $35K | 2.00% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | MEDICA INSURANCE COMPANY | $22K | — | $22K | 1.24% |
| WELLS FARGO INSURANCE SERVICES3 | 400 HIGHWAY 169 SOUTH 8TH FLOOR SAINT LOUIS PARK, MN 55426 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | — | $9K | 4.79% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 3.34% |
| WELLS FARGO INSURANCE SERVICES3 | PO BOX 30001 TAMPA, FL 33601 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 1.21% |
| WELLS FARGO INSURANCE SERVICES3 | 400 HIGHWAY 169 SOUTH 8TH FLOOR SAINT LOUIS PARK, MN 55426 | VISION SERVICE PLAN | $319 | — | $319 | 6.23% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | VISION SERVICE PLAN | $179 | — | $179 | 3.49% |
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 | 238 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 374 | $1.7M |
| Vision | VISION SERVICE PLAN | 27 | $5K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 246 | $189K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 246 | $189K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 246 | $189K |
| Prescription drug | MEDICA INSURANCE COMPANY | 374 | $1.7M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 246 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.