| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFIT GROUP, LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | RELIASTAR LIFE INSURANCE COMPANY | $4K | $2K | $6K | 7.12% |
| OSBORNE PROPERTIES LTD PTNRSHP3 Filed as: OSBORNE PROPERTIES LLP | 420 GATEWAY BLVD BURNSVILLE, MN 55337 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $91 | — | $91 | 1.41% |
| OSBORNE PROPERTIES LTD PTNRSHP3 Filed as: OSBORNE PROPERTIES LLP | 420 GATEWAY BLVD BURNSVILLE, MN 55337 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $47 | — | $47 | 0.91% |
| ELSIE M POLT3 | 201 W BURNSVILLE PKWY SUITE 116 BURNSVILLE, MN 55337 | AFLAC | $94 | — | $94 | 5.15% |
| MATTHEW R LORENZ3 | 1021 PROSPECT POINTE RD JORDAN, MN 55342 | AFLAC | $44 | — | $44 | 2.41% |
| DARIN D PAVLISH3 | 7760 FRANCE AVE S 1162 EDINA, MN 55435 | AFLAC | $22 | — | $22 | 1.21% |
| HAROLD D SCHWALM3 | 6413 BROOK LN SAVAGE, MN 55378 | AFLAC | $13 | — | $13 | 0.71% |
| JEFFREY PAUL GRIFFIN3 Filed as: JEFFREY ALLEN FOWLER | 6008 12TH AVE S MINNEAPOLIS, MN 55417 | AFLAC | $6 | — | $6 | 0.33% |
| JOHN PAUL THOMPSON SR3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $6 | — | $6 | 0.33% |
| CAROL SCHRECK3 | 4796 SAWGRASS DR W ANN ARBOR, MI 48108 | AFLAC | $5 | — | $5 | 0.27% |
| JESSE A REISCH3 | 1505 S MONTICELLO AVE SIOUX FALLS, SD 57106 | AFLAC | $3 | — | $3 | 0.16% |
| JEFFREY M HANSEN3 | 1895 52ND ST SW PEQUOT LAKES, MN 56472 | AFLAC | $3 | — | $3 | 0.16% |
| MICHELLE RAE MAGUIRE3 | 7825 WASHINGTON AVE S SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $3 | — | $3 | 0.16% |
| JEFFREY PAUL GRIFFIN3 Filed as: JEFFREY ALLEN FOWLER | 8613 E VIA DE SERENO SCOTTSDALE, AZ 85258 | AFLAC | $3 | — | $3 | 0.16% |
| BANYASH & ASSOCIATES INC3 | 4811 BEACH BLVD SUITE 107 JACKSONVILLE, FL 32207 | AFLAC | $2 | — | $2 | 0.11% |
| PEGGY SUE LAZER3 | 7914 113TH AVE N CHAMPLIN, MN 55316 | AFLAC | $2 | — | $2 | 0.11% |
| BARRY CAMPBELL3 | 2798 COUNTY RD 80 ALGER, OH 45812 | AFLAC | $2 | — | $2 | 0.11% |
| GREG A GOULD3 | 8105 GINGKO WAY DEXTER, MI 48130 | AFLAC | $1 | — | $1 | 0.05% |
| AG AND ASSOCIATES3 | 6155 GRAEBEAR TRL EAST LANSING, MI 48823 | AFLAC | $1 | — | $1 | 0.05% |
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 | 483 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 489 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 42 | $6K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 470 | $43K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 655 | $83K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 655 | $83K |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 655 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 655 | — |
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.