| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BLACK FINANCIAL SERVICES | 110 AVON AVENUE NORTH AVON, MN 56310 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $909 | $0 | $909 | 4.89% |
| BARTHELEMY, JACQUELINE M. - BOR3 | 7573 HILLTON ROAD ROYALTON, MN 56373 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $909 | $0 | $909 | 4.89% |
| BENEUSA LLC3 | PO BOX 1240 WATERTOWN, MN 55388 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $288 | $0 | $288 | 1.55% |
| BENEUSA LLC3 | 1851 LAKE DR W STE 350 CHANHASSEN, MN 55317 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $74 | $0 | $74 | 0.40% |
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 | 281 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 281 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 281 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.