| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| JACKI M BARTHELEMY3 | 7573 HILLTON RD ROYALTON, MN 56373 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.19% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES | PO BOX 346 AVON, MN 56310 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $0 | $5K | 4.18% |
| BENEUSA LLC3 | 1851 LAKE DR W STE 350 CHANHASSEN, MN 55317 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 2.79% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE M BARTHELEMY | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $12K | $3K | $15K | 14.16% |
| ASHLEY MARIA HOUTMAN3 | 3108 WESTEDGE BLVD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $2K | $462 | $3K | 2.68% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $2K | $943 | $3K | 2.56% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1K | $415 | $2K | 1.51% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $884 | $27 | $911 | 0.88% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $390 | $136 | $526 | 0.51% |
| JEFFREY MICHAEL OURADNIK3 | PO BOX 578 NISSWA, MN 56468 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $512 | $1 | $513 | 0.49% |
| JON OLSON3 | 360 CARLSON PARKWAY UNIT 302 MINNETONKA, MN 55305 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $378 | $63 | $441 | 0.42% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $155 | $1 | $156 | 0.15% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 900 NORTH SHORE DRIVE DETROIT LAKES, MN 56501 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $135 | $0 | $135 | 0.13% |
| CURTIS LARSON3 | 11626 YUKON ST NW COON RAPIDS, MN 55433 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $107 | $0 | $107 | 0.10% |
| ROBER SCOTT BRUNER3 | 24620 E CEDAR LAKE DR COON RAPIDS, MN 55433 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $42 | $65 | $107 | 0.10% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE IN | 1009 8TH AVE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $80 | $14 | $94 | 0.09% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $30 | $26 | $56 | 0.05% |
| BELL INSURANCE SERVICES3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $45 | $0 | $45 | 0.04% |
| WARNER AND COMPANY3 | PO BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $38 | $0 | $38 | 0.04% |
| ZACHARY GUSTAFSON3 | 9699 201ST AVE NW ELK RIVER, MN 55330 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $36 | $0 | $36 | 0.03% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $20 | $0 | $20 | 0.02% |
| PATRICK M MCGOWAN3 | 4401 PARK GLEN RD MINNEAPOLIS, MN 55416 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $16 | $0 | $16 | 0.02% |
| JACQUELINE BARTHELEMY3 Filed as: JACQUELINE M BARTHELEMY | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1K | $310 | $2K | 15.21% |
| ASHLEY MARIA HOUTMAN3 | 3108 WESTEDGE BLVD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $278 | $58 | $336 | 3.17% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $182 | $103 | $285 | 2.69% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $225 | $7 | $232 | 2.19% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $123 | $45 | $168 | 1.59% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $42 | $15 | $57 | 0.54% |
| JEFFREY MICHAEL OURADNIK3 | PO BOX 578 NISSWA, MN 56468 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $36 | $0 | $36 | 0.34% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 900 NORTH SHORE DR DETROIT LAKES, MN 56501 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $22 | $0 | $22 | 0.21% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $16 | $1 | $17 | 0.16% |
| CURTIS LARSON3 | 11626 YUKON ST NW COON RAPIDS, MN 55433 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $9 | $0 | $9 | 0.09% |
| BELL INSURANCE SERVICES3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $7 | $0 | $7 | 0.07% |
| WARNER AND COMPANY3 | PO BOX 1470 FARGO, ND 58107 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $4 | $0 | $4 | 0.04% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $2 | $1 | $3 | 0.03% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
| ROSE VILLALON PASQUEL3 | 552 E CARSON ST CARSON, CA 90745 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $50 | $7 | $57 | 2.06% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $24 | $1 | $25 | 0.90% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $9 | $0 | $9 | 0.33% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $8 | $0 | $8 | 0.29% |
| ELTHON ISRAEL CRUZ3 | 893 SOUTH 2100 WEST OREN, UT 84059 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $7 | $0 | $7 | 0.25% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $5 | $0 | $5 | 0.18% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $2 | $0 | $2 | 0.07% |
| MARIA RUBY QUINTANA3 | 112 N TOLAND AVE WEST COVINA, CA 91790 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1 | $0 | $1 | 0.04% |
| YOLO ENTERPRISE INC3 | 5460 E EL PRAUGE ST LONG BEACH, CA 90815 | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | $1 | $0 | $1 | 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 | 514 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 514 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 514 | $122K |
| Life insurance(4 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 514 | $240K |
| Other(3 contracts) | COLONIAL LIFE AND ACCIDENTAL INSURANCE COMPANY | 121 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 514 | — |
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.