| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 100 BLOOMINGTON, MN 55437 | THE UNION LABOR LIFE INSURANCE COMPANY | $25K | — | $25K | 3.00% |
| USI INSURANCE SERVICES LLC3 | 100 SUMMIT LAKE DR., SUITE 400 VALHALLA, NY 10595 | THE UNION LABOR LIFE INSURANCE COMPANY | $11K | — | $11K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE INSURANCE COMPANY EIN 36-2739571 NONE | Claims processing; Other fees Service code 12 | — | $1.4M |
| SHUMAKER, LOOP & KENDRICK, LLP EIN 34-4439491 NONE | Legal Service code 29 | — | $386K |
| TEAM LLC EIN 81-4050818 NONE | Contract Administrator Service code 13 | — | $223K |
| DDMN ASO, LLC EIN 41-1852523 NONE | Claims processing; Contract Administrator Service code 12 | — | $211K |
| CARLA GRUETZMACHER EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $210K |
| ANN KELLEN EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $179K |
| BRIDGEWAY BENEFIT TECHNOLOGIES EIN 82-3315217 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $140K |
| MEGAN ESPEDAL EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $119K |
| ARBOR RIDGE LLC EIN 41-2021746 NONE | Other services Service code 49 | — | $118K |
| SHARON HAFERKORN EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $110K |
| WENDEE LOCK EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $109K |
| GALLIARD CAPITAL MANAGEMENT, LLC EIN 41-1813702 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $108K |
| UNITED ACTUARIAL SERVICES EIN 35-2156428 NONE | Actuarial Service code 11 | — | $103K |
| MOLLY KNIEFEL EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $103K |
| JAEL LANG EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $89K |
| TIERRA CROMWELL EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $85K |
| DORENE MARTINEAU EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $84K |
| STEPHANIE COLBURN EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $84K |
| SAV-RX PRESCRIPTION SERVICES EIN 86-1323040 NONE | Claims processing; Contract Administrator Service code 12 | — | $84K |
| ASHLEY JEFFERSON EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $70K |
| KIMBERLY ODENBRETT EMPLOYEE | Employee (plan) Service code 30 | 6700 WEST BROADWAY AVENUE, SUITE B BROOKLYN PARK, MN 55428 | $64K |
| UNION BANK & TRUST COMPANY EIN 41-1267434 NONE | Other investment fees and expenses; Investment management fees paid directly by plan; Custodial (securities) Service code 19 | — | $62K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Claims processing Service code 12 | — | $62K |
| KUTAK ROCK LLP EIN 47-0597598 NONE | Legal Service code 29 | — | $51K |
| NOLOGY NETWORKS EIN 27-2294131 NONE | Other services Service code 49 | — | $44K |
| ASMED HEALTH, LLC EIN 27-4189010 NONE | Contract Administrator; Claims processing Service code 12 | — | $36K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $34K |
| HEALTH CARE SERVICE ADVISORS EIN 81-2790745 NONE | Consulting (general) Service code 16 | — | $33K |
| LEVEL 3 COMMUNICATIONS EIN 47-0807040 NONE | Other services Service code 49 | — | $25K |
| CORVEL HEALTHCARE CORPORATION EIN 95-3382819 NONE | Consulting (general) Service code 16 | — | $21K |
| LOOMIS SAYLES TRUST COMPANY EIN 20-8080381 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $20K |
| SEGAL MARCO ADVISORS EIN 13-2646110 NONE | Investment advisory (plan) Service code 27 | — | $15K |
| SYSTEM DESIGNS EIN 43-1228887 NONE | Other services Service code 49 | — | $15K |
| US BANK FINANCE EIN 31-0841368 NONE | Other services Service code 49 | — | $14K |
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 | 3,342 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,501 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,843 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 2,076 | $1.4M |
| Life insurance | THE UNION LABOR LIFE INSURANCE COMPANY | 3,314 | $211K |
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 3,595 | $828K |
| Other(2 contracts, 2 carriers) | THE UNION LABOR LIFE INSURANCE COMPANY | 3,600 | $282K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,600 | — |
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."
No prospect flags tripped on this filing.