| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PATRICIA BRUCE3 | 14541 BEVERLY LANE SAVAGE, MN 55378 | BLUE CROSS BLUE SHIELD MINNESOA | $11K | $1K | $12K | 4.03% |
| PATRICIA BRUCE | 14541 BEVERLY LANE SAVAGE, MN 55378 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.21% |
| DYSTE AGENCY INC Filed as: DYSTE AGENCY | 6465 WAYZATA BLVD MINNEAPOLIS, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.64% |
| PATRICIA BRUCE3 | 14541 BEVERLY LANE SAVAGE, MN 55378 | RELIANCE STANDARD | $2K | $0 | $2K | 9.22% |
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 | 103 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 106 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD MINNESOA | 103 | $309K |
| Dental | DELTA DENTAL OF MINNESOTA | 107 | $81K |
| Vision | RELIANCE STANDARD | 102 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $76K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $76K |
| Prescription drug | BLUE CROSS BLUE SHIELD MINNESOA | 103 | $309K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD MINNESOA | 103 | $309K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 114 | $76K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.