| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN MINNEAPOLIS | JOSEPH G KRUPELAK 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | $12K | $146 | $13K | 1.88% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | JOSEPH G KRUPELAK 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | $5K | $146 | $5K | 0.77% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN FL MAITLAND | JOSEPH G KRUPELAK 2290 LUCIEN WAY STE 400 MAITLAND, FL 32751 | MEDICA INSURANCE COMPANY | $2K | $146 | $2K | 0.27% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC | 80 S 8TH ST STE 700 MINNEAPOLOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 14.69% |
| MUELLER QAAS LLC3 Filed as: MUELLER QASS LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 7.47% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $250 | $250 | 1.15% |
| WATCH TOWER TECHNOLOGIES INC3 | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $244 | $244 | 1.12% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.47% |
| MUELLER QAAS LLC3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | — | $1K | 7.47% |
| WATCH TOWER TECHNOLOGIES INC3 | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $152 | $152 | 1.12% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $151 | $151 | 1.11% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $810 | — | $810 | 7.17% |
| MUELLER QAAS LLC3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $199 | — | $199 | 1.76% |
| WATCH TOWER TECHNOLOGIES INC3 | 306 W ERIE ST FL 3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $122 | $122 | 1.08% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | EYEMED | $293 | — | $293 | 5.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS., INC. | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | EYEMED | $79 | — | $79 | 1.52% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $723 | — | $723 | 18.07% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVS INC | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $48 | — | $48 | 1.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $222 | — | $222 | 7.35% |
| MUELLER QAAS LLC3 Filed as: MUELLER QASS LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $222 | — | $222 | 7.35% |
| WATCH TOWER TECHNOLOGIES INC3 | 306 W ERIE ST FL3 CHICAGO, IL 60654 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $33 | $33 | 1.09% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSET LOOP STE 304 MANASSAS, VA 20109 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $30 | $30 | 0.99% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $402 | — | $402 | 17.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVS INC | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35 | — | $35 | 1.56% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $410 | — | $410 | 18.41% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVS INC | 901 MARQUETTE AVE STE 1800 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $26 | — | $26 | 1.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DDMN ASO, LLC EIN 41-1852523 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $7K |
| HAYS COMPANIES INC AGENT/AGENCY | Insurance agents and brokers Service code 22 | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | $4K |
| BROWN & BROWN INSURANCE AGENT/AGENCY | Insurance agents and brokers Service code 22 | 2290 LUCIEN WAY MAITLAND, FL 32751 | $2K |
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 | 94 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 94 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 68 | $672K |
| Vision | EYEMED | 42 | $5K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 94 | $11K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 94 | $22K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 94 | $14K |
| Other(4 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 15 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 94 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.