| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $219K | $0 | $219K | 11.87% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON MIDWEST, INC. | 93076 NETWORK PLACE CHICAGO, IL 60673 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $19K | $0 | $19K | 1.06% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS. SERVICES | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $17K | $17K | 0.94% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 0.20% |
| SHELLY LUCKEN3 Filed as: SHELLY DAWN LUCKEN | 8233 WEST 133RD PLACE SAVAGE, MN 55378 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28K | $0 | $28K | 8.54% |
| HEATHER ANN PFLAUM3 | 4877 CLEARWATER CIRCLE SAVAGE, MN 55378 | CONTINENTAL AMERICAN INSURANCE COMPANY | $11K | $0 | $11K | 3.52% |
| LUCAS BAUMGARTNER3 | 667 158TH AVENUE NW ANDOVER, MN 55304 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 0.94% |
| TONYA L WYNES LLC3 Filed as: TONYA L. WYNES, LLC | 5810 WEST 78TH STREET, SUITE 210 MINNEAPOLIS, MN 55439 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 0.90% |
| WENDY RENARD3 Filed as: WENDY M. RENARD | 24133 FAWN COURT STACY, MN 55079 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.36% |
| TONYA LYNNE WYNES3 | 6017 SCENIC LAKE DRIVE GEORGETOWN, TX 78626 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 0.31% |
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 | 2,793 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 25 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,818 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY LIFE INSURANCE COMPANY | 4,333 | $222K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,793 | $1.8M |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,793 | $1.8M |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,793 | $1.8M |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,800 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,333 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.