| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACKI M BARTHELEMY3 | 7573 HILLTON RD ROYALTON, MN 563734007 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 4.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES INC | PO BOX 346 AVON, MN 56310 | PRINCIPAL LIFE INSURANCE COMPANY | $8K | $0 | $8K | 4.72% |
| BENEUSA LLC3 | 1851 LAKE DR W STE 350 CHANHASSEN, MN 553178567 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 3.15% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE M BARTHELEMY | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $13K | $4K | $16K | 18.12% |
| ASHLEY MARIA BARTHELEMY3 Filed as: ASHLEY MARIE HOUTMAN | 4011 BRADDOCK AVE NE BUFFALO, MN 55313 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $3K | $585 | $3K | 3.76% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $2K | $1K | $3K | 3.31% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1K | $502 | $2K | 1.83% |
| JEFFERY MICHAEL OURADNIK3 | 4203 PARKWAY DR NISSWA, MN 56468 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1K | $27 | $1K | 1.41% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $743 | $99 | $842 | 0.93% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $435 | $170 | $605 | 0.67% |
| CURTIS LARSON3 | 11626 YUKON ST NW COON RAPIDS, MN 55433 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $466 | $20 | $486 | 0.54% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $297 | $84 | $381 | 0.42% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $101 | $77 | $178 | 0.20% |
| MELIISA JEAN WOKASCH3 | 900 NORTH SHORE DR DETROIT LAKES, MN 56501 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $134 | $0 | $134 | 0.15% |
| NELS COREY JOHNSON3 Filed as: NELS CAREY JOHNSON | 25262 SLOTH ST NW ZIMMERMAN, MN 55398 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $96 | $0 | $96 | 0.11% |
| WARNER AND COMPANY3 | PO BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $86 | $0 | $86 | 0.10% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $38 | $4 | $42 | 0.05% |
| PATRICK M MCGOWAN3 | 4401 PARK GLEN RD MINNEAPOLIS, MN 55416 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $12 | $0 | $12 | 0.01% |
| JENNIFER GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $5 | $0 | $5 | 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 | 649 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 649 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 649 | $166K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 649 | $256K |
| Other | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | 243 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 649 | — |
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.