| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HARTFORD LIFE AND ACCIDENT | $31K | — | $31K | 2.07% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING IN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $10K | $10K | 0.68% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS ADMIN LLC | PO BOX 850502 MINNEAPOLIS, MN 55485 | HARTFORD LIFE AND ACCIDENT | $10K | — | $10K | 0.65% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | — | $7K | $7K | 0.49% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $35K | $30K | $65K | 7.59% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HUMAN RESOURCE CONSULTING IN | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.76% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.75% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN EIN 41-0984460 ADMINISTRATOR | Claims processing; Other fees; Contract Administrator; Legal; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.2M |
| DDMN ASO, LLC EIN 41-1852523 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $62K |
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 | 1,214 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1,668 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,882 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 3,370 | $1.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 7 | $238K |
| Vision(6 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 1,762 | $371K |
| Life insurance(2 contracts) | HARTFORD LIFE AND ACCIDENT | 1,451 | $1.8M |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,451 | $1.5M |
| Stop-loss / reinsurancereinsurance | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 3,370 | $854K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 3,016 | $1.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,370 | — |
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.