| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | MEDICA INSURANCE COMPANY | $56K | $6K | $62K | 4.44% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | DELTA DENTAL | $3K | — | $3K | 4.99% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 WEST 78TH STREET STE 100 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $815 | $5K | 13.28% |
| CARUTH, JENNON, M3 | PO BOX 46122 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $71 | $1K | 15.21% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 WEST 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $205 | $5 | $210 | 2.58% |
| NORTH RISK PARTNERS LLC3 Filed as: NORTH RISK PARTNERS MENDOTA | 622 ROOSEVELT RD STE 240 ST CLOUD, MN 56301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1 | — | $1 | 0.01% |
| CARRUTH, JENNON, M3 | PO BOX 46122 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INS CO | $960 | $39 | $999 | 14.77% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 WEST 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | PROVIDENT LIFE AND ACCIDENT INS CO | $169 | $8 | $177 | 2.62% |
| EMPLOYEE SECURITY PLANS3 | 151 E 22ND ST STE 101E LOMBARD, IL 60148 | PROVIDENT LIFE AND ACCIDENT INS CO | $26 | — | $26 | 0.38% |
| BEARANCE MANAGEMENT GROUP3 | 1045 76TH ST STE 4000 WEST DES MOINES, IA 50266 | PROVIDENT LIFE AND ACCIDENT INS CO | $8 | — | $8 | 0.12% |
| ASSUREX GLOBAL CORPORATION3 | 6630 MOONEY ST STE 360 DUBLIN, OH 43017 | PROVIDENT LIFE AND ACCIDENT INS CO | — | $7 | $7 | 0.10% |
| GUCKERT, HUGO, CHRISTOPHER3 Filed as: GUCKERT, HUGO CHRISTOPHER | 4500 BLACK ROCK RD STE 310 HAMPSTEAD, MD 21074 | PROVIDENT LIFE AND ACCIDENT INS CO | $5 | — | $5 | 0.07% |
| NORTH RISK PARTNERS LLC3 Filed as: NORTH RISK PARTNERS MENDOTA | 622 ROOSEVELT RD STE 240 ST CLOUD, MN 56301 | PROVIDENT LIFE AND ACCIDENT INS CO | — | — | $0 | 0.00% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | EYEMED VISION CARE | $97 | — | $97 | 2.66% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP | 9855 WEST 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $358 | $48 | $406 | 17.03% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 93 | $1.4M |
| Dental | DELTA DENTAL | 92 | $53K |
| Vision | EYEMED VISION CARE | 62 | $4K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $48K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $48K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $41K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 108 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.