| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $48K | $44K | $92K | 16.68% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $8K | $0 | $8K | 15.06% |
| JEFFREY M. HANSEN AND AGENTS3 | 1895 52ND STREET SW PEQUOT LAKES, MN 56472 | AFLAC | $1K | $0 | $1K | 3.86% |
| HEATHER K. WARE NELSON3 | 51482 WEST WYMER LAKE ROAD FRAZEE, MN 56544 | AFLAC | $621 | $0 | $621 | 2.28% |
| JOHN W. ZEPPER3 | 43680 MOSQUITO HEIGHTS ROAD PERHAM, MN 56573 | AFLAC | $522 | $0 | $522 | 1.91% |
| TERRY E ANDERSON3 Filed as: TERRY E. ANDERSON | 700 CEDAR STREET, SUITE 185 ALEXANDRIA, MN 56308 | AFLAC | $311 | $0 | $311 | 1.14% |
| CRAIG WAYNE SOTTILE3 Filed as: CRAIG CIMBURA | 407 SOUTH PARK DRIVE PIERZ, MN 56364 | AFLAC | $276 | $0 | $276 | 1.01% |
| KRISTIE L NOSBISH3 Filed as: KRISTIE L. NOSBISH | 432 18TH STREET NW SAUK RAPIDS, MN 56379 | AFLAC | $161 | $0 | $161 | 0.59% |
| SHELLY LUCKEN3 | 8233 WEST 133 ROAD PLACE SAVAGE, MN 55378 | AFLAC | $138 | $0 | $138 | 0.51% |
| USI INSURANCE SERVICES LLC4 | 800 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $1K | $0 | $1K | 9.65% |
| R WORLD, INC.4 | PO BOX 330 MERRIFIELD, MN 56465 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $102 | $0 | $102 | 0.94% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS OF NORTH AMERICA | PO BOX 4557 NEW YORK, NY 10249 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $80 | $0 | $80 | 0.74% |
| JULIIANA D. BRENTESON4 | 2532 183RD STREET NW BIG LAKE, MN 55309 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $29 | $0 | $29 | 0.27% |
| SHELLY HAUGLAND3 Filed as: SHELLY ANN HAUGLAND | 10410 265TH AVENUE NW ZIMMERMAN, MN 55398 | AFLAC | $123 | $0 | $123 | 2.36% |
| JOHN PAUL THOMPSON SR AND AGENTS3 | 6395 SOUTH KEWAUNEE WAY, SUITE 425 AURORA, CO 80016 | AFLAC | $64 | $0 | $64 | 1.23% |
| KATHI JO SWEETER3 | 10650 COUNTY ROAD 81, SUITE 224 MAPLE GROVE, MN 55369 | AFLAC | $51 | $0 | $51 | 0.98% |
| ANTHONY SWEETER3 Filed as: ANTHONY J. SWEETER | 13057 273RD AVENUE NW ZIMMERMAN, MN 55398 | AFLAC | $49 | $0 | $49 | 0.94% |
| WENDY RENARD3 Filed as: WENDY M. RENARD | 24133 FAWN COURT NE STACY, MN 55079 | AFLAC | $22 | $0 | $22 | 0.42% |
| LORI J THOMPSON3 Filed as: LORI J. THOMPSON | 1319 WEST MAIN STREET, UNIT 6 GUN BARREL CITY, TX 75156 | AFLAC | $19 | $0 | $19 | 0.36% |
| JEFFREY M HANSEN3 Filed as: JEFFREY M. HANSEN | 1895 52ND STREET SW PEQUOT LAKES, MN 56472 | AFLAC | $11 | $0 | $11 | 0.21% |
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 | 900 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 902 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 703 | $50K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 788 | $551K |
| Short-term disability(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 788 | $583K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 788 | $551K |
| Other(5 contracts, 4 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 900 | $599K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 900 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.