| 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 | $25K | $0 | $25K | 10.41% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE SUITE 400 BLOOMINGTON, MN 55437 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $471 | $8K | $9K | 3.59% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $75 | $1K | 0.61% |
| AHMANN MARTIN3 Filed as: AHMANN AND MARTIN COMPANY | 7555 MARKET PLACE DRIVE EDEN PRAIRIE, MN 55344 | RELIASTAR LIFE INSURANCE COMPANY | $17K | $0 | $17K | 10.00% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $13K | $862 | $14K | 8.53% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE SUITE 400 BLOOMINGTON, MN 55437 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $320 | $5K | 2.86% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC. | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $814 | $0 | $814 | 0.49% |
| RICHARD J. HEINRICH3 | 13921 BLENHEIM TRAIL ROAD FORT MYERS, FL 33908 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $368 | $0 | $368 | 0.22% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $283 | $0 | $283 | 0.17% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE SUITE 400 BLOOMINGTON, MN 55437 | UNITEDHEALTHCARE INSURANCE COMPANY | $3K | $0 | $3K | 9.20% |
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 | 417 | 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) | 417 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 492 | $27K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 417 | $409K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 380 | $167K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 417 | $242K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 554 | $413K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 554 | — |
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.