| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS CLEVELAND BENEFIT P | 7900 INTERNATIONAL DR STE 990 BLOOMINGTON, MN 55425 | MEDICA INSURANCE COMPANY | $59K | $2K | $61K | 2.27% |
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS CLEVELAND LLC--BRIAN JEN | 7900 INTERNATAIONAL DR #990 MINNEAPOLIS, MN 55425 | DELTA DENTAL OF MINNESOTA | $18K | — | $18K | 9.14% |
| ROY JENKS AND ASSOCIATES INC3 | 11100 WAYZATA BLVD STE 405 MINNETONKA, MN 55305 | DELTA DENTAL OF MINNESOTA | $2K | — | $2K | 0.77% |
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS CLEVELAND BENEFIT P | 7900 INTERNATIONAL DR STE 990 BLOOMINGTON, MN 55425 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $1K | $15K | 9.52% |
| SEVENHILLS CLEVELAND LLC8 Filed as: SEVENHILLS CLEVELAND BENEFIT P | 7900 INTERNATIONAL DR STE 990 BLOOMINGTON, MN 55425 | STARMOUNT LIFE INSURANCE COMPANY | $2K | $98 | $2K | 13.97% |
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 | 312 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 543 | $2.7M |
| Dental | DELTA DENTAL OF MINNESOTA | 509 | $201K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 170 | $12K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $160K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $160K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $160K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 126 | $160K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 543 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.