| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID MARTIN AGENCY INC3 | 6800 FRANCE AVE S STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $10K | $2K | $11K | 5.22% |
| DAVID MARTIN AGENCY INC3 | 6800 FRANCE AVE S STE 735 EDINA, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18K | $896 | $19K | 17.12% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | TWO PIERCE PLACE 21ST FLOOR ITASCA, IL 60143 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $639 | — | $639 | 5.04% |
| AHMANN MARTIN3 Filed as: AHMANN & MARTIN CO | 7555 MARKET PLACE DR EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $388 | — | $388 | 7.06% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFITS SERVICES INC | 3600 AMERICAN BLVD WEST BLOOMINGTON, MN 55431 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $72 | — | $72 | 2.58% |
| MARK A GROVE3 Filed as: MARK GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $34 | — | $34 | 1.22% |
| JENNIFER GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 1.11% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.97% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.25% |
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 | 601 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 603 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 431 | $23K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $328K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 6 | $5K |
| Long-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $231K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 609 | $331K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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.