| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 8331 NORMAN CENTER DR STE 500 BLOOMINGTON, MN 554374501 | MEDICA INSURANCE COMPANY | $40K | $4K | $44K | 2.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WADE JOHNSON WELLS FARGO INSURANCE | 4300 MARKET PLACE DRIVE 600 BLOOMINGTON, MN 55435 | DEAN HEALTH PLAN INC | $9K | — | $9K | 3.30% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | 8000 NORMAN CENTER DR STE 400 BLOOMINGTON, MN 554371180 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $3K | $13K | 9.27% |
| 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 | $468 | $22 | $490 | 3.09% |
| MIDWEST SELECT INSURANCE GROUP LLC3 Filed as: MIDWEST SELECT INSURANCE | STE 101 301 MAIN STREET MOSINEE, WI 54455 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $343 | — | $343 | 2.16% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE - ST LOUIS PA | P.O. BOX 203373 DALLAS, TX 753203373 | EYEMED VISION CARE | $1K | — | $1K | 9.19% |
| 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 | $315 | $12 | $327 | 2.53% |
| MIDWEST SELECT INSURANCE GROUP LLC3 | STE 101 301 MAIN STREET MOSINEE, WI 54455 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $301 | — | $301 | 2.32% |
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES NATIONAL INC | 400 HIGHWAY 169 SOUTH ST LOUIS PARK, MN 55426 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $143 | — | $143 | 15.05% |
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 | 347 | 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) | 347 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 288 | $2.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 264 | $136K |
| Vision | EYEMED VISION CARE | 212 | $15K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 264 | $136K |
| Short-term disability(2 contracts, 2 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 69 | $29K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 69 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.