| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ASSOCIATED BEN. AND RISK CONSULTING3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | PREFERREDONE INSURANCE COMPANY | $16K | — | $16K | 2.15% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 234662817 | PREFERREDONE INSURANCE COMPANY | $6K | — | $6K | 0.83% |
| EMPLOYEE BENEFIT ADVANTAGES INC3 Filed as: EMPLOYEE BENEFIT ADVANTAGE INC | 14740 BOWERS DR NW RAMSEY, MN 55303 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.31% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DR KIMBERLY, WI 54136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $968 | — | $968 | 2.73% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $396 | — | $396 | 1.12% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $165 | — | $165 | 0.47% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $162 | — | $162 | 0.46% |
| CARRIE S FLATEN3 | 2606 86TH COURT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $136 | — | $136 | 0.38% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 3357 POLK ST NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $107 | — | $107 | 0.30% |
| DESIREE WENDELL3 | 38269 EVERTON AVENUE NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.16% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE SAINT PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | — | $31 | 0.09% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| NATALIE SUZANNE FONVILLE3 | 1600 THOMAS AVE N MINNEAPOLIS, MN 55411 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| SABRINA S RAMOS3 | 13750 W COLONIAL DR WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| ROBERT SCOTT BRUNER3 | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| USI INSURANCE SERVICES LLC3 | 6000 CLEARWATER DRIVE MINNETONKA, MN 55343 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $32 | $3K | 15.16% |
| USI INSURANCE SERVICES LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $355 | $355 | 1.84% |
| ASSOCIATED FINANCIAL GROUP LLC3 | 711 EISENHOWER DRIVE KIMBERLY, WI 54136 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $674 | — | $674 | 10.05% |
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 | 169 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | 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. | 91 | $7K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 169 | $55K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 55 | $35K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 169 | $19K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 169 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.