| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | TOKIO MARINE HCC | $45K | $3K | $48K | 10.73% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | P.O. BOX 748422 ATLANTA, GA 303748422 | TOKIO MARINE HCC | — | $15K | $15K | 3.29% |
| UPPER MIDWEST LABOR/MGMT HEALTHCARE3 | P.O. BOX 69 ROSEMOUNT, MN 55068 | VISION SERVICE PLAN | $233 | — | $233 | 0.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Contract Administrator; Claims processing; Accounting (including auditing); Plan Administrator Service code 10 | — | $360K |
| UMR, INC. EIN 39-1995276 NONE | Contract Administrator; Other fees; Claims processing Service code 12 | — | $175K |
| FOX ROTHSCHILD LLP EIN 23-1404723 NONE | Legal Service code 29 | — | $35K |
| MORGAN STANLEY SMITH BARNEY EIN 26-4310632 NONE | Direct payment from the plan; Investment management; Custodial (securities) Service code 19 | — | $24K |
| UNITED ACTUARIAL SERVICES INC. EIN 35-2156428 NONE | Actuarial Service code 11 | — | $18K |
| TEAM, INC. EIN 81-4050818 NONE | Contract Administrator; Claims processing Service code 12 | — | $16K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $14K |
| DDMN ASO, LLC EIN 41-1852523 NONE | Contract Administrator; Claims processing Service code 12 | — | $14K |
| CVS PHARMACY INC. EIN 05-0340626 NONE | Claims processing; Contract Administrator Service code 12 | — | $5K |
| FELHABER LARSON EIN 41-0991071 NONE | Legal Service code 29 | — | $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 | 720 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 69 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 789 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MINNESOTA | 25 | $68K |
| Vision | VISION SERVICE PLAN | 543 | $52K |
| Life insurance(2 contracts) | THE UNION LABOR LIFE INSURANCE COMPANY | 429 | $30K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MINNESOTA | 25 | $44K |
| Stop-loss / reinsurancereinsurance | TOKIO MARINE HCC | 614 | $449K |
| Other(2 contracts) | THE UNION LABOR LIFE INSURANCE COMPANY | 429 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 614 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.