| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE SEGAL COMPANY3 Filed as: SEGAL | 333 WEST 34TH STREET NEW YORK, NY 10001 | BCBSM, INC. D.B.A BLUE CROSS BLUESHIELD OF MN | $43K | — | $43K | 11.10% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MN EIN 41-0984460 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $511K |
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Direct payment from the plan; Contract Administrator Service code 13 | — | $490K |
| THE SEGAL COMPANY EIN 13-1975125 NONE | Insurance agents and brokers; Direct payment from the plan; Consulting (general) Service code 16 | — | $126K |
| PRIME THERAPEUTICS EIN 26-0076803 NONE | Direct payment from the plan; Claims processing; Other services; Other fees Service code 12 | — | $63K |
| DELTA DENTAL EIN 41-1905554 NONE | Claims processing; Direct payment from the plan Service code 12 | — | $55K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $28K |
| T.E.A.M. EIN 83-0469948 NONE | Direct payment from the plan; Consulting (general) Service code 16 | — | $26K |
| LONGFELLOW INVESTMENT CO EIN 04-2933956 NONE | Direct payment from the plan; Investment management; Investment management fees paid directly by plan Service code 28 | — | $22K |
| MCGRANN SHEA CARNIVAL STRAUGHN LAMB EIN 41-1654544 NONE | Legal; Direct payment from the plan Service code 29 | — | $18K |
| MEKETA INVESTMENT GROUP EIN 04-2659023 NONE | Investment advisory (plan); Direct payment from the plan Service code 27 | — | $15K |
| UNION BANK AND TRUST EIN 41-1267434 NONE | Direct payment from the plan Service code 50 | — | $15K |
| ST. CROIX PRESS NONE | Other fees Service code 99 | 1185 S. KNOWLES AVE. NEW RICHMOND, WI 54017 | $9K |
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 | 1,587 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 485 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,072 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSM, INC. D.B.A BLUE CROSS AND BLUESHIELD OF MINNESOTA | 510 | $1.1M |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 1,616 | $192K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 510 | $559K |
| Stop-loss / reinsurancereinsurance | BCBSM, INC. D.B.A BLUE CROSS BLUESHIELD OF MN | 2,039 | $386K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 1,616 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,039 | — |
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."
No prospect flags tripped on this filing.