| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $9K | $19K | 22.34% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $2K | $14K | 16.00% |
| ROBERT SCOTT BRUNER3 | 987 LACY CT BELLE PLAINE, MN 56011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 3.51% |
| JON OLSON3 | 5650 W 36TH ST APT 509 ST. LOUIS PARK, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $450 | $2K | 2.81% |
| ZACKARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $134 | $2K | 2.44% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $791 | $2K | 2.40% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $671 | $2K | 2.26% |
| JASON RYAN LOWREY3 | 705 CREEKSIDE LANE LITITZ, PA 17543 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $760 | $19 | $779 | 0.92% |
| TAMMY M DAHLBERG3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $646 | $89 | $735 | 0.87% |
| DEBORAH LYNN WELLS3 | 5809 MARK TWAIN AVENUE SACRAMENTO, CA 95820 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $453 | $68 | $521 | 0.61% |
| KATHLEEN MORELAND3 | 6025 EQUESTRIAN TERRACE ROCKLIN, CA 95677 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $453 | $14 | $467 | 0.55% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $177 | $178 | $355 | 0.42% |
| ANDREW CHARLES FELLS3 | 331 W HUMPHREY STREET LAKE CRYSTAL, MN 56055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $167 | $20 | $187 | 0.22% |
| T NASH SKILES INC3 | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | $71 | $139 | 0.16% |
| BLUE SKY BENEFIT SOLUTIONS INC3 | 1500 39TH ST SOUTH SAINT CLOUD, MN 56301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $76 | $137 | 0.16% |
| DARRYL W VIDOR3 | 104 PIONEER DR. FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $81 | $43 | $124 | 0.15% |
| BENECHOICE ENROLLMENT SOLUTIONS3 Filed as: BENECHOICE ENROLLMENT SOLUTIONS INC | 1574 LITITZ PIKE LANCASTER, PA 17601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | $48 | $116 | 0.14% |
| JACK ALAN HENNINGSGAARD3 | 2562 LOST LAKE RD MOUND, MN 55364 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $53 | $114 | 0.13% |
| MARDEIO CANNON3 | 5027 DYNASTY WAY SACRAMENTO, CA 95835 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $81 | $3 | $84 | 0.10% |
| ASHLEA HUMPHRIES-SHARP3 | 2514 DOWNS ST BOSSIER CITY, LA 71111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | — | $69 | 0.08% |
| BRIAN TATES3 | 146 MOOR ROAD SHREVEPORT, LA 71106 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $19 | $25 | 0.03% |
| GILES CONSULTING GROUP INC3 | 3554 FOUNTAINBLEAU RD KEITHVILLE, LA 71047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $8 | $14 | 0.02% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.00% |
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 | 168 | 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) | 168 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 240 | $85K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 240 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.