| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ANDERSON INSURANCE & INVST AGENCY3 Filed as: ANDERSON INSURANCE AGENCY | 312 CENTRAL AVENUE SE SUITE 392 MINNEAPOLIS, MN 55414 | THE UNION LABOR LIFE INSURANCE COMPANY | $7K | — | $7K | 1.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ZENITH AMERICAN SOLUTIONS EIN 52-1590516 PLAN ADMINISTRATOR | Contract Administrator; Direct payment from the plan Service code 13 | — | $914K |
| LEONARD, O'BRIEN, SPENCER, GALE EIN 41-0956652 NONE | Legal; Direct payment from the plan Service code 29 | — | $239K |
| MEDICA ACCESS EIN 41-1479417 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $196K |
| MILLIMAN INC EIN 91-0675641 NONE | Consulting (general); Direct payment from the plan; Actuarial Service code 11 | — | $111K |
| MAIRS & POWER, INC EIN 41-0844499 NONE | Investment management fees paid directly by plan; Investment advisory (plan) Service code 27 | — | $70K |
| PILOT CAPITAL MANAGEMENT EIN 41-1599308 NONE | Investment management; Direct payment from the plan; Investment management fees paid directly by plan Service code 28 | — | $70K |
| DDMN ASO, LLC EIN 41-1905554 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $40K |
| LABOR HEALTHWORKS NONE | Direct payment from the plan; Contract Administrator Service code 13 | 1970 OAKCREST AVE. SUITE 119 ROSEVILLE, MN 55113 | $30K |
| T.E.A.M., INC. EIN 83-0469948 NONE | Contract Administrator; Direct payment from the plan Service code 13 | — | $27K |
| LASERMARK, INC. EIN 41-1703180 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $26K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $19K |
| UNION BANK & TRUST EIN 41-1267434 NONE | Direct payment from the plan; Custodial (securities) Service code 19 | — | $19K |
| QUALITY RESOURCE GROUP EIN 41-1762007 NONE | Copying and duplicating; Direct payment from the plan Service code 36 | — | $16K |
| VISION SERVICE PLAN EIN 06-1227840 NONE | Direct payment from the plan; Contract Administrator; Insurance brokerage commissions and fees Service code 13 | — | $11K |
| HEALTHWORKS COALITION NONE | Direct payment from the plan; Consulting (general) Service code 16 | 700 TRANSFER ROAD ST. PAUL, MN 55114 | $7K |
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 | 1,415 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 191 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,606 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance | THE UNION LABOR LIFE INSURANCE COMPANY | 1,422 | $370K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,422 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.