| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $20K | $0 | $20K | 11.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $7K | $7K | 3.86% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | PO BOX 46122 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $26 | $1K | 0.65% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $389 | $0 | $389 | 0.23% |
| GCG FINANCIAL LLC3 Filed as: CLARITY COMPANY, LLC | PO BOX 46122 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $66 | $0 | $66 | 0.04% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | PO BOX 46122 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $154 | $6K | 4.79% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 1.56% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 1 NORTH WHITE HORSE PIKE, SUITE 2 HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $498 | $613 | $1K | 0.88% |
| RICHARD J. HEINRICH3 | 13921 BLENHEIM TRAIL ROAD FORT MYERS, FL 33908 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $221 | $0 | $221 | 0.18% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $146 | $0 | $146 | 0.12% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $99 | $99 | 0.08% |
| AHMANN MARTIN3 Filed as: AHMANN & MARTIN COMPANY | 7555 MARKET PLACE DRIVE EDEN PRAIRIE, MN 55344 | RELIASTAR LIFE INSURANCE COMPANY | $12K | $0 | $12K | 10.00% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | UNITEDHEALTHCARE INSURANCE COMPANY | $2K | $0 | $2K | 9.96% |
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 | 399 | 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) | 399 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 186 | $20K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $298K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 287 | $126K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 330 | $172K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 427 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 427 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.