| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JAMES L CLAIRMONT3 Filed as: JAMES R WEIR INSURANCE AGENCY | 208 NORTH BROAD STREET MANKATO, MN 56001 | HEALTHPARTNERS INC | — | $14K | $14K | 1.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3600 AMERICAN BLVD WEST SUITE 500 BLOOMINGTON, MN 55431 | HEALTHPARTNERS INC | — | $4K | $4K | 0.47% |
| CORPORATE HEALTH SYSTEMS INC3 | 15153 TECHNOLOGY DRIVE SUITE B EDEN PRAIRIE, MN 55344 | HEALTHPARTNERS INC | — | $3K | $3K | 0.46% |
| NICHOLAS J HOHN3 | 3137 SHORES BLVD WAYZATA, MN 553912838 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $159 | $3K | 8.80% |
| CORPORTATE HEALTH SYSTEMS INC3 | 15153 TECHNOLOGY DR EDEN PRARIE, MN 553442220 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $77 | $1K | 3.25% |
| NICHOLAS J HOHN3 | 3137 SHORES BLVD WAYZATA, MN 553912838 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.89% |
| CORPORATE HEALTH SYSTEMS INC3 | 15153 TECHNOLOGY DR EDEN PRAIRIE, MN 553442220 | PRINCIPAL LIFE INSURANCE COMPANY | $520 | — | $520 | 5.25% |
| BROKER LISTING ATTACHED3 | — | AFLAC | $1K | — | $1K | 12.97% |
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 | 112 | 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) | 112 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHPARTNERS INC | 180 | $755K |
| Dental | HEALTHPARTNERS INC | 180 | $755K |
| Vision | AFLAC | 19 | $9K |
| Life insurance(2 contracts) | PRINCIPAL LIFE INSURANCE COMPANY | 287 | $48K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 287 | $47K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 287 | $38K |
| Other | AFLAC | 19 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 287 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.