| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, STE 700 MINNEAPOLIS, MN 55402 | HCC LIFE INSURANCE COMPANY | $85K | — | $85K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | P.O. BOX 748422 ATLANTA, GA 303748422 | HCC LIFE INSURANCE COMPANY | — | $35K | $35K | 4.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Plan Administrator; Claims processing; Contract Administrator Service code 12 | — | $455K |
| UMR, INC. EIN 39-1995276 NONE | Claims processing; Other fees Service code 12 | — | $277K |
| CVS PHARMACY INC. EIN 05-0340626 NONE | Claims processing Service code 12 | — | $28K |
| DDMN ASO LLC EIN 41-1852523 NONE | Contract Administrator; Claims processing Service code 12 | — | $23K |
| MINNESOTA TEAMSTERS SERVICE BUREAU EIN 41-1513000 NONE | Contract Administrator; Claims processing Service code 12 | — | $17K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $16K |
| UNITED ACTUARIAL SERVICES, INC. EIN 35-2156428 NONE | Actuarial Service code 11 | — | $15K |
| FELHABER LARSON EIN 41-0991071 NONE | Legal Service code 29 | — | $14K |
| FOX ROTHSCHILD LLP NONE | Legal Service code 29 | 222 S. NINTH STREET, SUITE 200 MINNEAPOLIS, MN 554023338 | $12K |
| HONSA-BINDER PRINTING, INC EIN 41-1605232 NONE | Copying and duplicating Service code 36 | — | $5K |
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 | 1,213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 10 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,223 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNION LABOR LIFE INSURANCE COMPANY | 0 | $42K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 829 | $848K |
| Other | UNION LABOR LIFE INSURANCE COMPANY | 0 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 829 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.