| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA INC. | JULIE M. HIRMAN 1600 UTICA AVE S, STE 600 MINNEAPOLIS, MN 554163687 | MEDICA INSURANCE COMPANY | $33K | $1K | $35K | 3.43% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MN INC. | 1600 UTICA AVE S, STE 600 MINNEAPOLIS, MN 554163687 | BCBSM, INC. D.B.A. BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $4K | $8 | $4K | 1.63% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA INC. | 93076 NETWORK PL. CHICAGO, IL 60673 | SUN LIFE ASSURANCE COMPANY OF CANADA | $10K | — | $10K | 6.70% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA, INC. | 1600 UTICA AVE S, STE 600 MINNEAPOLIS, MN 55416 | UNION SECURITY INSURANCE COMPANY | $3K | $46 | $3K | 32.77% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS - HRH | 93076 NETWORK PLACE CHICAGO, IL 606731930 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $378 | — | $378 | 9.11% |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 79 | $1.2M |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $150K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 73 | $4K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $150K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $150K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $150K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 102 | $158K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 102 | — |
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."
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.