| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACKI M BARTHELEMY3 | 7573 HILLTON RD ROYALTON, MN 56373 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | — | $5K | 4.73% |
| 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 | $5K | — | $5K | 4.73% |
| BENEUSA LLC3 | 1851 LAKE DR W STE 350 CHANHASSEN, MN 55317 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 3.15% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE BERTHELEMY | 7573 HILLTON RD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $1K | $7K | 14.72% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $732 | $494 | $1K | 2.59% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 1100 11TH AVE SE ST CLOUD, MN 56304 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $637 | $38 | $675 | 1.42% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 12549 STILKE LAKE RD FRAZEE, MN 56544 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $466 | $6 | $472 | 1.00% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $307 | $130 | $437 | 0.92% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN LOFFATT LUCAS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $248 | $153 | $401 | 0.85% |
| WARNER AND COMPANY3 | P O BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $114 | — | $114 | 0.24% |
| PATRICK M MCGOWAN3 | 4401 PARK GLEN RD MINNEAPOLIS, MN 55416 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.04% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $1 | $4 | 0.01% |
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 | 420 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 419 | $103K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 419 | $151K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 129 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 419 | — |
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.