| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 4300 MARKET POINTE DR, SUITE 600 BLOOMINGTON, MN 554355455 | RELIASTAR LIFE INSURANCE COMPANY | $127K | — | $127K | 8.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS - ST. LOUIS PARK | P.O. BOX 203373 DALLAS, TX 753203373 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $7K | — | $7K | 11.19% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SER. USA, INC | 400 HIGHWAY 169 SOUTH, 8TH FLOOR ST. LOUIS PARK, MN 55426 | HYATT LEGAL PLANS, INC. | $5K | — | $5K | 9.97% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SER. USA, INC | 64 MONROE AVENUE NW, SUITE 300 GRAND RAPIDS, MI 495031453 | HYATT LEGAL PLANS, INC. | — | $808 | $808 | 1.57% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SER. USA, INC | 1018 W 9TH AVENUE KING OF PRUSSIA, PA 194061225 | HYATT LEGAL PLANS, INC. | — | $27 | $27 | 0.05% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS - ST. LOUIS PARK | P.O. BOX 203373 DALLAS, TX 753203373 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $748 | — | $748 | 3.23% |
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 | 2,990 | 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) | 2,990 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,647 | $66K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 3,195 | $1.5M |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 3,195 | $1.5M |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 3,195 | $1.5M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 3,195 | $1.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,195 | — |
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.