| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | DELTA DENTAL OF MINNESOTA | $11K | $0 | $11K | 10.01% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $1K | $10K | 8.94% |
| VAALER INSURANCE INC3 Filed as: VAALER INSURANCE INC. | 2701 SOUTH COLUMBIA ROAD PO BOX 12848 GRAND FORKS, ND 58201 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $143 | $0 | $143 | 0.13% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | $0 | $2K | 10.00% |
| WORKPLACE SOLUTIONS, INC.3 | 120-A GILLS CREEK PARKWAY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $333 | $4K | 32.80% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $133 | $2K | 13.68% |
| BEAU DAVID BOUDREAUX3 | 120 GILLS CREEK PARKWAY COLUMBIA, SC 29209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $280 | $0 | $280 | 2.53% |
No Schedule C service providers reported on this filing.
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 | 387 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 387 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 255 | $115K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 185 | $24K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $123K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $112K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $112K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 144 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 255 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.