| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACKI M BARTHELEMY3 | 7573 HILLTON RD ROYALTON, MN 56373 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES INC | 110 AVON AVE N P O BOX 346 AVON, MN 56310 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 4.49% |
| BENEUSA LLC3 | 1851 LAKE DR W STE 350 CHANHASSEN, MN 55317 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 3.16% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE RD FRAZEE, MN 56544 | PRINCIPAL LIFE INSURANCE COMPANY | $380 | — | $380 | 0.51% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE BERTHELEMY | 7573 HILLTON RD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $6K | 11.97% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE RD FRAZEE, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $109 | $1K | 3.07% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $558 | $348 | $906 | 1.96% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 1100 11TH AVE SE ST CLOUD, MN 56304 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $566 | $66 | $632 | 1.37% |
| WARNER AND COMPANY3 | P O BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $169 | — | $169 | 0.37% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $126 | $28 | $154 | 0.33% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN LOFFATT LUCAS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $30 | $84 | 0.18% |
| EDWARD D SOMMER3 Filed as: EDWARD CHRIS ROSENLUND | 8672 MEADOWVALE DR EDEN PRAIRIE, MN 55347 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | — | $79 | 0.17% |
| PATRICK M MCGOWAN3 | 4401 PARK GLEN RD MINNEAPOLIS, MN 55416 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.04% |
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 | 352 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 352 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 366 | $75K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 366 | $121K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 136 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 366 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.