| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CARUTH, JENNON, M0 | 6400 FLYING CLOUD DRIVE, STE. 215 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $21K | $2K | $23K | 13.24% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | — | $7K | 4.08% |
| CUSTOM BENEFIT PROGRAMS INC0 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $949 | $2K | 1.44% |
| HENINRICH, RICHARD J.0 | 13921 BLENHEIM TRAIL ROAD FT MEYERS, FL 33908 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $694 | — | $694 | 0.40% |
| DAVID MARTIN AGENCY INC3 | 6800 FRANCE AVENUE S, STE 735 EDINA, MN 55435 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $584 | — | $584 | 0.34% |
| AHMANN MARTIN3 Filed as: AHMANN & MARTIN CO | 7555 MARKET PLACE DR EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $218 | — | $218 | 0.13% |
| BENEFIT ADVISORS NETWORK LLC0 Filed as: BENEFIT ADVISORS NETWORK | 6830 COCHRAN ROAD SOLON, OH 44139 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2 | $2 | 0.00% |
| AHMANN MARTIN3 Filed as: AHMANN & MARTIN COMPANY | 7555 MARKET PLACE DR EDEN PRAIRIE, MN 553443637 | RELIASTAR LIFE INSURANCE COMPANY | $11K | — | $11K | 8.06% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC. | 6800 FRANCE AVE S., STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $749 | $16K | 16.99% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC. | 6800 FRANCE AVE S., STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $552 | $5K | 7.86% |
| CARUTH, JENNON, M3 | 6400 FLYING CLOUD DR, STE 215 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $943 | $3K | 11.76% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $528 | — | $528 | 2.46% |
| DAVID MARTIN AGENCY INC3 Filed as: DAVID MARTIN AGENCY INC. | 6800 FRANCE AVE S., STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12 | — | $12 | 0.06% |
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 | 343 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 348 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 201 | $24K |
| Life insurance(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 453 | $264K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 453 | $171K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 270 | $67K |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 453 | $422K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 453 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.