| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 701 B ST, FLOOR 6 SAN DIEGO, CA 92101 | MEDICA INSURANCE COMPANY | $49K | $3K | $53K | 1.50% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | ATTN RUSSELL L BERMAN 701 B ST FLOOR 6 SAN DIEGO, CA 92101 | MEDICA INSURANCE COMPANY | $31K | $3K | $34K | 0.98% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC AL | ATTN RUSSELL BERMAN 2211 7TH AVE S BIRMINGHAM, AL 35233 | MEDICA INSURANCE COMPANY | $16K | $3K | $19K | 0.55% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | ATTN ERICA MENDEZ 701 B ST, STE 600 SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21K | $6K | $26K | 7.44% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SE SUITE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $446 | $3K | 0.96% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $4K | $8K | 13.30% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 15400 28TH AVENUE NORTH PLYMOUTH, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 11.80% |
| LINDA PARKER3 | 2067 26TH AVE NW ROCHESTER, MN 55901 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.69% |
| JEFFREY D HARNED3 Filed as: JEFFREY LYLES | 3872 BALLANTRAE RD EAGAN, MN 55122 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $910 | $26 | $936 | 1.47% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $572 | $250 | $822 | 1.29% |
| CURTIS LARSON3 | 11626 YUKON ST NW COON RAPIDS, MN 55433 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $708 | $30 | $738 | 1.16% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $658 | $67 | $725 | 1.14% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $452 | $223 | $675 | 1.06% |
| ATB INSURANCE INC3 | 15861 60TH AVE NORTH PLYMOUTH, MN 55446 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $547 | $1 | $548 | 0.86% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $370 | $143 | $513 | 0.81% |
| JON OLSON3 | 6050 W 135TH ST SAVAGE, MN 55378 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $439 | $48 | $487 | 0.76% |
| NELS COREY JOHNSON3 | 25262 SLOTH ST NW ZIMMERMAN, MN 55398 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $437 | — | $437 | 0.69% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $144 | $334 | 0.52% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $283 | $13 | $296 | 0.46% |
| SCOTT DANIEL JOHNSON3 | 4745 NARVIK DRIVE EAGN, MN 55122 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $208 | — | $208 | 0.33% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $125 | $76 | $201 | 0.32% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET, STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $183 | $8 | $191 | 0.30% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $132 | $18 | $150 | 0.24% |
| DESIERREE WENDELL3 | 38269 EVERTON AVENUE NORTH BRANCH, MN 55056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $71 | — | $71 | 0.11% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 3357 POLK ST NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $9 | $50 | 0.08% |
| EMPLOYEE BENEFIT ADVANTAGES INC3 | 14740 BOWERS DR NW RAMSEY, MN 55303 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $1 | $47 | 0.07% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $2 | $37 | 0.06% |
| ASHLEY MARIA HOUTMAN3 | 4011 BRADDOCK AVE NE BUFALO, MN 55313 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $29 | $6 | $35 | 0.05% |
| GRANT CREIGHTON ROCKWOOD3 | 2832 HARRIET AVENUE MINNEAPOLIS, MN 55408 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $22 | — | $22 | 0.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.03% |
| CORY KENNETH KNUDSON3 | 2012 108TH LANE NW MINNEAPOLIS, MN 55433 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.02% |
| ELIZABETH C OVERBO3 | 97235 PLEASANT AVE S BLOOMINGTON, MN 55420 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.02% |
| JACK ALAN HENNINGSGAARD3 | 2562 LOST LAKE RD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $4 | $8 | 0.01% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3600 AMERICAN BOULEVARD WEST BLOOMINGTON, MN 55431 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.01% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.01% |
| SHIRLEY B DRAKE3 Filed as: SHIRLEY JOHNSON | 17505 DEERFIELD DR SE PRIOR LAKE, MN 55372 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | ATTN ERICA MENDEZ 701 B ST, STE 600 SAN DIEGO, CA 92101 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $433 | $2K | 14.72% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SE STE 300 ATLANTA, GA 30339 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $479 | $24 | $503 | 3.07% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 320 WEST 57TH STREET 3RD FLOOR NEW YORK, NY 10019 | EYEMED | $855 | — | $855 | 5.30% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 701 B STREET 6TH FLOOR SAN DIEGO, CA 92101 | EYEMED | $440 | — | $440 | 2.73% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 3400 OVERTON PARK DRIVE SUITE 300 ATLANTA, GA 30339 | EYEMED | $288 | — | $288 | 1.79% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | 101 PARK AVENUE 14TH FLOOR NEW YORK, NY 10178 | EYEMED | $165 | — | $165 | 1.02% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES | ATTN ERICA MENDEZ 701 B STREET, STE 600 SAN DIEGO, CA 92101 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | — | $6K | 35.02% |
| FRED HAUENSTEIN3 | 13370 HUNTINGTON CIRCLE APPLE VALLEY, MN 55124 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 7.31% |
| HAROLD L WINTERHALTER3 | 3870 TROY LANE N PLYMOUTH, MN 55446 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.07% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $249 | $149 | $398 | 8.70% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SERVICES INC | 15400 28TH AVENUE NORTH PLYMOUTH, MN 55447 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $362 | — | $362 | 7.91% |
| GERALD A GEENEN3 | ONE TOWER LANE OAKBROOK TERRACE, IL 60181 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $298 | $31 | $329 | 7.19% |
| MARK D BARBIER3 Filed as: MARK BARBIER | 23 CROYDON LANE OAK BROOK, IL 60523 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $23 | $38 | $61 | 1.33% |
| HENRY J SAMAAN3 Filed as: HENRY JACOB SAMAAN | 19W 152 21ST PLACE LOMBARD, IL 60148 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $23 | $33 | $56 | 1.22% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $35 | $13 | $48 | 1.05% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $28 | $12 | $40 | 0.87% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $22 | $8 | $30 | 0.66% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $28 | — | $28 | 0.61% |
| ROBERTA DICKINSON3 Filed as: ROBERTA J BAKKEN | 8012 W CORNING RD PEOTONE, IL 60468 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $12 | — | $12 | 0.26% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 3357 POLK STREET NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $6 | — | $6 | 0.13% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE CO | $3 | — | $3 | 0.07% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $39 | — | $39 | 4.74% |
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 | 290 | 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) | 290 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 551 | $3.5M |
| Vision | EYEMED | 263 | $16K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 448 | $372K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 448 | $356K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 448 | $356K |
| Other(8 contracts, 5 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 448 | $495K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 551 | — |
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.