| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $134K | $8K | $143K | 3.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | HARTFORD LIFE AND ACCIDENT | $22K | $5K | $27K | 12.01% |
| SHERI R MEIS3 Filed as: SHERI RENAE MEIS | 12121 165TH AVENUE FERGUS FALLS, MN 56537 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 2.62% |
| TERRY E ANDERSON3 Filed as: TERRY EARL ANDERSON | 7477 CO ROAD 21 SW ALEXANDRIA, MN 56308 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 1.41% |
| PAULA KAY DAVENPORT3 | 1008 FRONTIER DRIVE, SUITE 101 FERGUS FALLS, MN 56537 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 1.09% |
| ARIEL MARIE NOVAK3 | 28985 OGREN TRAIL CENTER CITY, MN 55012 | CONTINENTAL AMERICAN INSURANCE COMPANY | $802 | $0 | $802 | 0.63% |
| KELLI RHEAUME3 | 13430 EAST LAKE MILTONA DRIVE NE MILTONA, MN 56354 | CONTINENTAL AMERICAN INSURANCE COMPANY | $5 | $0 | $5 | 0.00% |
| 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 | 8.44% |
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 | 360 | 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) | 360 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 403 | $3.9M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 387 | $25K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 360 | $222K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 360 | $222K |
| Prescription drug | MEDICA INSURANCE COMPANY | 403 | $3.8M |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 360 | $387K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 403 | — |
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.