| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC CO | 6160 GOLDEN HILLS DRIVE MINNEAPOLIS, MN 55416 | DELTA DENTAL OF MINNESOTA | $14K | $0 | $14K | 11.28% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | $0 | $6K | 13.86% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $0 | $4K | 13.91% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $468 | $0 | $468 | 2.28% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR #400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $312 | $0 | $312 | 1.52% |
| LEGACY BENEFIT CONSULTANTS3 | 5121 SUNDANCE RUN MAYER, MN 55360 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $0 | $190 | 0.93% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $188 | $0 | $188 | 0.92% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $114 | $0 | $114 | 0.56% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE N MINNEAPOLIS, MN 55428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $94 | $0 | $94 | 0.46% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $71 | $0 | $71 | 0.35% |
| JON OLSON3 | 360 CARLSON PARKWAY UNIT 302 MINNETONKA, MN 55305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $67 | $0 | $67 | 0.33% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.23% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $37 | $0 | $37 | 0.18% |
| ATB INSURANCE INC3 | 8654 SOUTH MAPLEBROOK CIRCLE BROOKLYN PARK, MN 55445 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.10% |
| ANDREW CHARLES FELLS3 | PO BOX 74 LAKE CRYSTAL, MN 56055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.08% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6505 DEMPSEY AVE SW WAVERLY, MN 55390 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $0 | $16 | 0.08% |
| ZACKARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | $0 | $14 | 0.07% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $0 | $13 | 0.06% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 2019 4TH AVE N APT 202 SAUK RAPIDS, MN 56379 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.04% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.03% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
| JENNIFER COLLEEN DYNAN3 | 1367 4 BRONZE PARKWAY ROSEMOUNT, MN 55068 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.01% |
| JEFFREY D HARNED3 Filed as: JEFFREY LYLES | 3872 BALLANTRAE RD EAGAN, MN 55122 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $0 | $3K | 20.44% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE N #300 MINNEAPOLIS, MN 55428 | EYEMED | $1K | $0 | $1K | 12.41% |
| MARSH & MCLENNAN AGENCY LLC3 | 6160 GOLDEN HILLS DRIVE MINNEAPOLIS, MN 55416 | EYEMED | $852 | $0 | $852 | 7.64% |
| MARSH & MCLENNAN AGENCY LLC3 | 2300 RENAISSANCE BLVD KING OF PRUSSIA, PA 19406 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 13.56% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $128 | $1 | $129 | 2.21% |
| LEGACY BENEFIT CONSULTANTS3 | 5121 SUNDANCE RUN MAYER, MN 55360 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $82 | $0 | $82 | 1.40% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $55 | $3 | $58 | 0.99% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE N MINNEAPOLIS, MN 55428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $49 | $1 | $50 | 0.86% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DR #400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $43 | $0 | $43 | 0.74% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $33 | $0 | $33 | 0.56% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $28 | $5 | $33 | 0.56% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $2 | $21 | 0.36% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $21 | $0 | $21 | 0.36% |
| ATB INSURANCE INC3 | 8654 SOUTH MAPLEBROOK CIRCLE BROOKLYN PARK, MN 55445 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.29% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | $0 | $11 | 0.19% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.02% |
| MARSH & MCLENNAN AGENCY LLC3 | 7225 NORTHLAND DRIVE N MINNEAPOLIS, MN 55428 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $96 | $7 | $103 | 11.44% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $60 | $29 | $89 | 9.89% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $7 | $31 | 3.44% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $11 | $26 | 2.89% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $11 | $17 | 1.89% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $3 | $10 | 1.11% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $2 | $7 | 0.78% |
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 | 182 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 252 | $123K |
| Vision | EYEMED | 159 | $11K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 182 | $45K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 66 | $30K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 14 | $15K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 142 | $260K |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 182 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 252 | — |
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.