| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAVID ELLINGSON3 Filed as: DAVID ELLINGSON C/O ELLINGSON INSUR | 1016 CIVIC CENTER DR NW SUITE 102 ROCHESTER, MN 55901 | USABLE LIFEMEDICA INSURANCE COMPANY | $28K | $0 | $28K | 3.00% |
| JOHN TUSETH3 | 5821 LOWRY DRIVE NW ROCHESTER, MN 55901 | AFLAC | $11K | $314 | $12K | 10.30% |
| MICHAEL D SCHULTZ3 | 1815 14TH ST. NW ROCHESTER, MN 55901 | AFLAC | $981 | $16 | $997 | 0.89% |
| TRACI NATOLI3 | 2774 COMMERCE DRIVE NW1145 CHENOA L ORONOCO, MN 55960 | AFLAC | $708 | $47 | $755 | 0.67% |
| PATRICK A NATOLI3 Filed as: PATRICK NATOLI | 1145 CHENOA LN SW ORONOCO, MN 55960 | AFLAC | $557 | $47 | $604 | 0.54% |
| DONALD LARRY REYNOLDS3 | 8945 33RD ST. N #B LAKE ELMO, MN 55042 | AFLAC | $242 | $0 | $242 | 0.22% |
| BARRY CAMPBELL3 | 2798 COUNTY ROAD 80 ALGER, OH 45812 | AFLAC | $237 | $0 | $237 | 0.21% |
| BRICE L CAMPBELL3 Filed as: BRICE CAMPBELL | 360 LIBERTY HEIGHTS DR CHASKA, MN 55318 | AFLAC | $188 | $0 | $188 | 0.17% |
| MICHELLE RAE MAGUIRE3 | 7825 WASHINGTON AVE. S. SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $148 | $0 | $148 | 0.13% |
| DARIN D PAVLISH3 | 7760 FRANCE AVE. SOUTH 1162 EDINA, MN 55435 | AFLAC | $142 | $0 | $142 | 0.13% |
| MIKE YURCZYK3 Filed as: MIKE YURCYZK | 901 MARQUETTE AVE. SUITE 1500 MINNEAPOLIS, MN 55402 | AFLAC | $128 | $0 | $128 | 0.11% |
| JERMEY L THOMLINSON3 | 7825 WASHINGTON AVE. S SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $79 | $47 | $126 | 0.11% |
| CHRISTOPHER J KUZNIEWSKI3 | 3747 9TH AVE. SW ROCHESTER, MN 55902 | AFLAC | $112 | $0 | $112 | 0.10% |
| CATHY J OLIVER3 | 201 WEST BURNESVILLE PKWY SUITE 116 BURNSVILLE, MN 55337 | AFLAC | $93 | $0 | $93 | 0.08% |
| JOHN PAUL THOMPSON SR3 | 6395 S. KEWAUNEE WAY SUITE 425 AURORA, CO 80016 | AFLAC | $81 | $0 | $81 | 0.07% |
| STACI ANN CHASE3 | 709 15TH ST. SE ROCHESTER, MN 55904 | AFLAC | $58 | $0 | $58 | 0.05% |
| MICHAEL D SCHULTZ3 Filed as: MICHAEL J AXTELL | 3562 6TH PL NW ROCHESTER, MN 55901 | AFLAC | $39 | $0 | $39 | 0.03% |
| DOUGLAS J SCHWINGLER3 | 3158 ROSEMARY LANE NE ROCHESTER, MN 55906 | AFLAC | $34 | $0 | $34 | 0.03% |
| ELLINGSON INSURANCE GROUP LLC3 Filed as: ELLINGSON INSURANCE GROUP | 1016 CIVIC CENTER DR. NW SUITE 102 ROCHESTER, MN 55901 | USABLE LIFE | $3K | $0 | $3K | 12.66% |
| BENEUSA LLC3 | 1851 LAKE DRIVE WEST SUITE 350 CHANHASSEN, MN 55317 | USABLE LIFE | $950 | $0 | $950 | 3.80% |
| DAVID ELLINGSON3 Filed as: DAVID ELLINGSON C/O ELLINGSON INS | 1016 CIVIC CENTER DR. NW SUITE 102 ROCHESTER, MN 55901 | USABLE LIFE | $585 | $0 | $585 | 2.34% |
| ELLINGSON INSURANCE GROUP LLC3 | 1016 CIVIC CENTER DR. NW SUITE 102 ROCHESTER, MN 55901 | USABLE LIFE | $803 | $0 | $803 | 12.64% |
| BENEUSA LLC3 | 1851 LAKE DRIVE WEST SUITE 350 CHANHASSEN, MN 55317 | USABLE LIFE | $241 | $0 | $241 | 3.79% |
| DAVID ELLINGSON3 Filed as: DAVID ELLINGSON C/O ELLINGSON INSUR | 1016 CIVIC CENTER DR. NW SUITE 102 ROCHESTER, MN 55901 | USABLE LIFE | $150 | $0 | $150 | 2.36% |
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 | 178 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | USABLE LIFEMEDICA INSURANCE COMPANY | 175 | $1.0M |
| Dental | AFLAC | 175 | $112K |
| Vision | AFLAC | 175 | $112K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 175 | $118K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 175 | $137K |
| Prescription drug(2 contracts, 2 carriers) | USABLE LIFEMEDICA INSURANCE COMPANY | 161 | $946K |
| Other(2 contracts, 2 carriers) | AFLAC | 175 | $118K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 175 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.