| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH RISK PARTNERS LLC3 | — | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (BCBSND) | $17K | — | $17K | 1.00% |
| HAJOSTEK, PATRICIA A3 | 1508 ALEXANDER AVENUE CROOKSTON, MN 56716 | STARMOUNT LIFE INSURANCE COMPANY | $2K | — | $2K | 10.72% |
| PATRICIA HAJOSTEK3 | 1508 ALEXANDER AVE CROOKSTON, MN 56716 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 14.62% |
| DEACON CHARLES KAVANAUGH3 | 6336 HILL CREEK DR THE COLONY, TX 75056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $141 | $43 | $184 | 1.92% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $57 | $94 | $151 | 1.57% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $54 | $57 | $111 | 1.16% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $26 | $27 | $53 | 0.55% |
| MPART BENEFITS INC3 Filed as: MPART BENEFITS INC. | 100 ALBRIGHT LN PROSPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $20 | $36 | 0.38% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $2 | $26 | 0.27% |
| NATALIE SUZANNE FONVILLE3 | 2415 ZENITH AVE N GOLDEN VALLEY, MN 55422 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.15% |
| BLUE SKY BENEFIT SOLUTIONS INC3 | 4010 CLEARWATER RD APT 202 SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.11% |
| BRENDA LEE CANNING3 | 4227 THRU ST SAINT CLOUD, MN 56303 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | — | $10 | 0.10% |
| CARRIE S FLATEN3 | 27028 86TH CT W NORTH FIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | — | $5 | 0.05% |
| TIMOTHY STERLING3 | 1314 PLUMWOOD CT WAITE PARK, MN 56387 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.03% |
| NICOLE TOWNSEND VEDDER3 | 6548 WILDEMEADE PL TALLAHASSEE, FL 32309 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.03% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DR RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.02% |
| JOEY MIGUES3 Filed as: JOEY GRUBBS BENEFITS LLC | 525 TAYLOR RD MONTICELLO, FL 32344 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| DAVID J MCCLELLAN3 Filed as: DAVID B MERKHOFER | 2704 SETTER PL TALLAHASSEE, FL 32303 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| PATRICIA HAJOSTEK3 | 1508 ALEXANDER AVE CROOKSTON, MN 56716 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $626 | — | $626 | 36.46% |
| DEACON CHARLES KAVANAUGH3 | 6336 HILL CREEK DR THE COLONY, TX 75056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $69 | $25 | $94 | 5.47% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $24 | $56 | $80 | 4.66% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $32 | $35 | $67 | 3.90% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $15 | $27 | 1.57% |
| MPART BENEFITS INC3 Filed as: MPART BENEFITS INC. | 100 ALBRIGHT LN PROSPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $10 | $12 | $22 | 1.28% |
| PATRICIA HAJOSTEK3 | 1508 ALEXANDER AVE CROOKSTON, MN 56716 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $159 | — | $159 | 26.72% |
| DEACON CHARLES KAVANAUGH3 | 6336 HILL CREEK DR THE COLONY, TX 75056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | $7 | $26 | 4.37% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $15 | $22 | 3.70% |
| ROBERT SCOTT BRUNER3 | 24620 E. CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $10 | $19 | 3.19% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $4 | $7 | 1.18% |
| MPART BENEFITS INC3 Filed as: MPART BENEFITS INC. | 100 ALBRIGHT LN PROPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3 | $3 | $6 | 1.01% |
| NATALIE SUZANNE FONVILLE3 | 2415 ZENITH AVE N GOLDEN VALLEY, MN 55422 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.17% |
| BLUE SKY BENEFIT SOLUTIONS INC3 | 4010 CLEARWATER RD APT 202 SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| TIMOTHY STERLING3 | 1314 PLUMWOOD CT WAITE PARK, MN 56387 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| BRENDA LEE CANNING3 | 4227 THRU ST SAINT CLOUD, MN 56303 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DR RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| PATRICIA HAJOSTEK3 | 1508 ALEXANDER AVE CROOKSTON, MN 56716 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $147 | — | $147 | 26.16% |
| CHARLES DEACON KAVANAUGH3 | 6336 HILL CREEK DR THE COLONY, TX 75056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $16 | $5 | $21 | 3.74% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6 | $7 | $13 | 2.31% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $8 | $12 | 2.14% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | C/O NATL ENROLLMENT PARTNERS CRANSTON, RI 02920 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5 | $7 | $12 | 2.14% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.53% |
| MPART BENEFITS INC3 Filed as: MPART BENEFITS INC. | 100 ALBRIGHT LN PROSPER, TX 75078 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $2 | $3 | 0.53% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| STRATACOR EIN 41-1852523 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $9K |
| PATRICIA A HAJOTEK | Insurance agents and brokers Service code 22 | — | $3K |
| PATRICIA A HAJOSTEK AGENT/AGENCY | Insurance agents and brokers Service code 22 | 1508 ALEXANDER AVENUE CROOKSTON, MN 56716 | $0 |
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 | 138 | 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) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (BCBSND) | 226 | $1.7M |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 85 | $15K |
| Other(4 contracts) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 29 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.