| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $30K | $5K | $35K | 7.78% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62939 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $19 | $19 | 0.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $7K | $0 | $7K | 14.97% |
| SHARON CIMBURA3 Filed as: SHARON CIMBURA AND OTHER AGENTS | 115 SCHOENES DRIVE SW PIERZ, MN 56364 | AFLAC | $1K | $0 | $1K | 3.60% |
| HEATHER WARE NELSON3 | 51482 WEST WYMER LAKE ROAD FRAZEE, MN 56544 | AFLAC | $836 | $0 | $836 | 2.44% |
| DENICE ZEPPER3 | 250 8TH AVENUE SW, APARTMENT 1 PERHAM, MN 56573 | AFLAC | $590 | $0 | $590 | 1.72% |
| TERRY E ANDERSON3 Filed as: TERRY ANDERSON | 700 CEDAR STREET, SUITE 185 ALEXANDRIA, MN 56308 | AFLAC | $414 | $0 | $414 | 1.21% |
| CRAIG WAYNE SOTTILE3 Filed as: CRAIG CIMBURA | 115 SCHOENES DRIVE SW PIERZ, MN 56364 | AFLAC | $319 | $0 | $319 | 0.93% |
| KRISTIE NOSBISH3 | 432 18TH STREET NW SAUK RAPIDS, MN 56379 | AFLAC | $238 | $0 | $238 | 0.69% |
| JEFFREY D HARNED3 Filed as: JEFFREY HANSEN | 1895 52ND STREET SW PEQUOT LAKES, MN 56472 | AFLAC | $141 | $0 | $141 | 0.41% |
| SHELLY HAUGLAND3 | 10410 265TH AVENUE NW ZIMMERMAN, MN 55398 | AFLAC | $257 | $0 | $257 | 2.22% |
| ANTHONY SWEETER3 | 13057 273RD AVENUE NW ZIMMERMAN, MN 55398 | AFLAC | $236 | $16 | $252 | 2.17% |
| LAURA BUCK3 Filed as: LAURA BUCK AND OTHER AGENTS | 915 JASMINE PARKE DRIVE APARTMENT 3 BAKERSFIELD, CA 93312 | AFLAC | $193 | $7 | $200 | 1.73% |
| KATHI JO SWEETER3 Filed as: KATHI SWEETER | 10650 COUNTY ROAD 81, SUITE 224 MAPLE GROVE, MN 55369 | AFLAC | $109 | $0 | $109 | 0.94% |
| WENDY RENARD3 | 24133 FAWN COURT NE STACY, MN 55079 | AFLAC | $48 | $0 | $48 | 0.41% |
| LORI J THOMPSON3 Filed as: LORI THOMPSON | 1600 PRESIDENT GEORGE BUSH HIGHWAY APARTMENT 6101 ROWLETT, TX 75088 | AFLAC | $44 | $0 | $44 | 0.38% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | AFLAC | $34 | $0 | $34 | 0.29% |
| USI INSURANCE SERVICES LLC4 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $210 | $0 | $210 | 4.45% |
| R WORLD, INC.4 | PO BOX 330 MERRIFIELD, MN 56465 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $136 | $0 | $136 | 2.89% |
| WILLIS TOWERS WATSON US LLC4 Filed as: WILLIS OF NORTH AMERICA | ONE WORLD FINANCIAL CENTER 200 LIBERTY STREET NEW YORK, NY 10281 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $126 | $0 | $126 | 2.67% |
| JULIANA D BRENTESON4 Filed as: JULIANA D. BRENTESON | 2532 183RD STREET NW BIG LAKE, MN 55309 | PRE-PAID LEGAL SERVICES INC DBA LEGAL SHIELD | $31 | $0 | $31 | 0.66% |
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 | 694 | 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) | 694 | 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. | 690 | $46K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,632 | $451K |
| Short-term disability(3 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,632 | $497K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 1,632 | $451K |
| Other(5 contracts, 4 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,632 | $508K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,632 | — |
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.