| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $117K | $4K | $121K | 3.62% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $18K | $0 | $18K | 9.88% |
| USI INSURANCE SERVICES LLC3 | 8331 NORMAN CENTER DRIVE, SUITE 500 BLOOMINGTON, MN 55437 | HARTFORD LIFE AND ACCIDENT | $0 | $4K | $4K | 2.39% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 8.10% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $402 | $0 | $402 | 1.42% |
| SHARON L. KONIECZNY3 | 12610 50TH AVENUE PLYMOUTH, MN 55442 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $351 | $0 | $351 | 1.24% |
| CARRIE S FLATEN3 Filed as: CARRIE S. FLATEN | 2606 86TH COURT WEST NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $275 | $0 | $275 | 0.97% |
| NATALIE SUZANNE FONVILLE3 Filed as: NATALIE S. FONVILLE AND OTHER AGENT | 1600 THOMAS AVENUE NORTH MINNEAPOLIS, MN 55411 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $267 | $0 | $267 | 0.94% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $160 | $0 | $160 | 0.57% |
| LACIE M SWARTZENDRUBER3 Filed as: LACIE M. SWARTZENDRUBER | 2211 151ST AVENUE NW ANDOVER, MN 55304 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $125 | $0 | $125 | 0.44% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | $0 | $2K | 10.81% |
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 | 341 | 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) | 341 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 415 | $3.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 345 | $23K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 341 | $178K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 341 | $178K |
| Prescription drug | MEDICA INSURANCE COMPANY | 415 | $3.3M |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 341 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 415 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.