| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 6160 GOLDEN HILLS DR GOLDEN VALLEY, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $607 | $6K | 16.22% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 886 POPLAR LN WATERTOWN, MN 55388 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $242 | $1K | 3.98% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $322 | $368 | $690 | 1.86% |
| ATB INSURANCE INC3 | 6505 DEMPSEY AVE SW WAVERLY, MN 55390 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $360 | $14 | $374 | 1.01% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $248 | $96 | $344 | 0.93% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST.PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $248 | $50 | $298 | 0.80% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $249 | $35 | $284 | 0.77% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $137 | $60 | $197 | 0.53% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $48 | — | $48 | 0.13% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.07% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $5 | $20 | 0.05% |
| MARY-JOYCE LICATA3 Filed as: MARY J YARNELL | 170 E HAMILTON LN BATTLE CREEK, MI 49015 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| ALEXANDER OTTONIEL CANAS3 | 27448 RIVERSIDE LN VALENCIA, CA 91354 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.03% |
| PAMELA KAY LONG3 | 200 S. LEXINGTON DRIVE FOLSOM, CA 95630 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| CAROLYN GROVER3 | 206 FOX CHAPEL DR IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.01% |
| DESIREE WENDELL3 | 39050 HARDER PKWY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| CASSANDRA KRAMER3 | 1465 N AUGUST DR SARATOGA SPGS, UT 84045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| BROCKSTAR LLC3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 107 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 107 | — |
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.