| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WADE JOHNSON WELLS FARGO INSURANCE | 400 HWY 169 S FLOOR 8 ST. LOUIS PARK, MN 55426 | MEDICA INSURANCE COMPANY | $33K | $4K | $37K | 2.61% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WADE JOHNSON WELLS FARGO INSURANCE | 4300 MARKET PLACE DRIVE 600 BLOOMINGTON, MN 55435 | DEAN HEALTH PLAN INC | $8K | — | $8K | 2.93% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SERVICES USA INC | 400 HIGHWAY 169 S, 8TH FLOOR ST LOUIS PARK, MN 55426 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | $2K | $11K | 8.84% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA INC | 10 S WACKER DRIVE FL 17 CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $830 | $830 | 0.64% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE | STE 101 301 MAIN STREET MOSINEE, WI 54455 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 36.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC | 400 HWY 169 S SAINT LOUIS PARK, MN 55426 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $935 | $7K | 28.00% |
| MIDWEST SELECT INSURANCE GROUP LLC3 | STE 101 301 MAIN STREET MOSINEE, WI 54455 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 33.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS. SVCS USA, INC. | ST LOUIS PARK, 400 HWY 169 S SAINT LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $577 | $5K | 24.89% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE - ST LOUIS PA | P.O. BOX 203373 DALLAS, TX 753203373 | EYEMED VISION CARE | $1K | — | $1K | 10.89% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 400 HIGHWAY 169 SOUTH ST LOUIS PARK, MN 55426 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $174 | — | $174 | 15.00% |
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 | 408 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 229 | $1.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 260 | $129K |
| Vision | EYEMED VISION CARE | 183 | $12K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 260 | $130K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 116 | $43K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 116 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 260 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.