| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | DONN G SCROGGINS 7225 NORTHLAND DR N SUITE 300 MINNEAPOLIS, MN 554281575 | MEDICA INSURANCE COMPANY | — | $19K | $19K | 0.63% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | RJF 7225 NORTHLAND DRIVE SUITE 300 MINNEAPOLIS, MN 55428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $57K | $5K | $62K | 15.29% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE N SUITE 300 MINNEAPOLIS, MN 55428 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $10K | — | $10K | 4.73% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | RJF 7225 NORTHLAND DR SUITE 300 MINNEAPOLIS, MN 55428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $2K | $10K | 6.42% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE N SUITE 300 MINNEAPOLIS, MN 554281575 | VISION SERVICE PLAN | $15K | — | $15K | 10.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | RJF 7225 NORTHLAND DR SUITE 300 MINNEAPOLIS, MN 55428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $23K | $2K | $25K | 16.41% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY | RJF 7225 NORTHLAND DR SUITE 300 MINNEAPOLIS, MN 55428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $905 | $11K | 15.26% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE SUITE 300 MINNEAPOLIS, MN 55428 | METROPOLITAN LIFE INSURANCE COMPANY | $8K | $38 | $8K | 28.73% |
| MARSH & MCLENNAN AGENCY LLC3 | 250 PEHLE AVE SUITE 400 PARK 80 PLAZA 2 SADDLE BROOK, NJ 076635832 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 4.34% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | RFJ, A MARSH MCLENNAN LLC COMPANY 7225 NORTHLAND DRIVE NORTH STE 300 MINNEAPOLIS, MN 55428 | HYATT LEGAL PLANS | $2K | — | $2K | 9.12% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC | RFJ, A MARSH MCLENNAN LLC COMPANY 7225 NORTHLAND DRIVE NORTH STE 300 MINNEAPOLIS, MN 55428 | HYATT LEGAL PLANS | $337 | — | $337 | 1.24% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA, INC | MARSH MCLENNAN AGENCY, LLC 500 BOYLSTON STREET, STE 300 BOSTON, MA 02116 | HYATT LEGAL PLANS | — | $107 | $107 | 0.39% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: RJF AGENCIES, INC. | 7225 NORTHLAND DRIVE NORTH SUITE 300 MINNEAPOLIS, MN 554281516 | HYATT LEGAL PLANS | — | $75 | $75 | 0.28% |
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 | 17 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,464 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,481 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 755 | $3.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 866 | $204K |
| Vision | VISION SERVICE PLAN | 855 | $154K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,266 | $407K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 945 | $151K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,481 | $163K |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,266 | $535K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,266 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.