| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $46K | $18K | $64K | 11.83% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $27K | $9K | $36K | 6.60% |
| ROBERT SCOTT BRUNER3 | 24620 EAST CEDAR LAKE DRIVE NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $5K | $11K | 11.62% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT AND OTHER AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $315 | $5K | 5.48% |
| CARLOS PAEZ3 | 2905 NW 130TH AVENUE APARTMENT 102 SUNRISE, FL 33323 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $1K | $5K | 5.21% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $566 | $4K | 3.79% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $9 | $4K | 3.76% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $1K | $3K | 2.84% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $678 | $261 | $939 | 1.00% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $10K | $0 | $10K | 16.06% |
| ROBERT SCOTT BRUNER3 | 24620 EAST CEDAR LAKE DRIVE NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 7.76% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $3 | $4K | 7.11% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $431 | $3K | 4.88% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $854 | $693 | $2K | 2.78% |
| ASSUREDPARTNERS3 Filed as: BERTHA PATRICIA SHEPHERD | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $430 | $68 | $498 | 0.89% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT AND OTHER AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $355 | $102 | $457 | 0.82% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $314 | $90 | $404 | 0.72% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN GENERAL INSURANCE COMPANY | $1K | $0 | $1K | 9.93% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62889 VIRGINIA BEACH, VA 23466 | METROPOLITAN GENERAL INSURANCE COMPANY | $0 | $111 | $111 | 0.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $792 | — | $792 | 7.31% |
| ROBERT SCOTT BRUNER3 | 24620 EAST CEDAR LAKE DRIVE NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $402 | $263 | $665 | 6.14% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE ST PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $430 | $71 | $501 | 4.63% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $128 | $88 | $216 | 1.99% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $12 | $66 | 0.61% |
| JILL R LAMBERT3 Filed as: JILL R. LAMBERT | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $46 | $10 | $56 | 0.52% |
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 | 1,055 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 9 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,064 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 880 | $62K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,055 | $544K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,055 | $544K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,055 | $544K |
| Other(5 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 1,055 | $718K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,055 | — |
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.