| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INS SERVICES LLC | CHRISTOPHER S HANSEN PO BOX 62817 VIRGINIA BEACH, VA 23466 | MEDICA INSURANCE COMPANY | $10K | — | $10K | 1.32% |
| OTIS-MAGIE INSURANCE AGENCY, INC.3 Filed as: OTIS-MAGIE INSURANCE AGENCY INC | HEATHER A CAREY 332 W SUPERIOR ST STE 700 DULUTH, MN 55802 | MEDICA INSURANCE COMPANY | $4K | $434 | $5K | 0.63% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR SUITE 400 MINNEAPOLIS, MN 55437 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $836 | — | $836 | 7.33% |
| WHEELER ASSOCIATES3 | 306 W SUPERIOR ST STE 1600 DULUTH, MN 55802 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $305 | — | $305 | 2.67% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR SUITE 400 MINNEAPOLIS, MN 55437 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $446 | — | $446 | 8.52% |
| WHEELER ASSOCIATES3 | 306 W SUPERIOR ST STE 1600 DULUTH, MN 55802 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $130 | — | $130 | 2.48% |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 91 | $736K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 144 | $17K |
| Prescription drug | MEDICA INSURANCE COMPANY | 91 | $736K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 144 | — |
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.