| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | PRINCIPAL LIFE INSURANCE COMPANY | $23K | $8K | $31K | 6.74% |
| CHRISTENSEN GROUP INC3 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | EYEMED VISION CARE | $2K | — | $2K | 10.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HEALTHY ALLIANCE LIFE INSURANCE CO EIN 86-0257201 | Other services; Claims processing; Contract Administrator; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $277K |
| CHRISTENSEN GROUP INC 86-0257201 | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $33K |
| CHRISTENSEN GROUP INC EIN 86-0257201 | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| INGENIORX, INC. EIN 82-3062245 | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Float revenue; Claims processing Service code 12 | — | -$48K |
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 | 174 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 176 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 135 | $420K |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $458K |
| Vision | EYEMED VISION CARE | 139 | $22K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $458K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $458K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 174 | $458K |
| Stop-loss / reinsurancereinsurance | HEALTHY ALLIANCE LIFE INSURANCE COMPANY | 135 | $420K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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.