| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $224K | $43K | $267K | 12.99% |
| ADP INC3 Filed as: ADP, LLC | PO BOX 842875 BOSTON, MA 02284 | STANDARD INSURANCE COMPANY | — | $21K | $21K | 1.75% |
| ADP INC3 Filed as: ADP INC. | PO BOX 711 C5 PORTLAND, OR 97207 | STANDARD INSURANCE COMPANY | — | $20K | $20K | 1.70% |
| LOCKTON COMPANIES, LLC3 | PO BOX 671284 DALLAS, TX 75267 | STANDARD INSURANCE COMPANY | $126K | — | $126K | 26.66% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | STANDARD INSURANCE COMPANY | $6K | — | $6K | 1.22% |
| LOCKTON COMPANIES, LLC3 | PO BOX 173850 DENVER, CO 80217 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 0.91% |
| ADP INC3 Filed as: ADP, LLC | PO BOX 842875 BOSTON, MA 02284 | STANDARD INSURANCE COMPANY | — | $6K | $6K | 1.77% |
| ADP INC3 Filed as: ADP INC. | PO BOX 711 C5 PORTLAND, OR 97207 | STANDARD INSURANCE COMPANY | — | $6K | $6K | 1.73% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | EYEMED VISION CARE | $31K | — | $31K | 9.95% |
| ADP INC3 Filed as: ADP, LLC | PO BOX 842875 BOSTON, MA 02284 | STANDARD INSURANCE COMPANY | — | $4K | $4K | 1.78% |
| ADP INC3 Filed as: ADP INC. | PO BOX 711 C5 PORTLAND, OR 97207 | STANDARD INSURANCE COMPANY | — | $4K | $4K | 1.70% |
| LOCKTON COMPANIES, LLC4 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $13K | — | $13K | 12.00% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $5K | — | $5K | 5.00% |
| GERALI, MICHAEL C3 | 5200 SOUTH ULSTER STREET, APT 1819 GREENWOOD VILLAGE, CO 80111 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 10.74% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | FEDERAL INSURANCE COMPANY | $732 | — | $732 | 20.01% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | FEDERAL INSURANCE COMPANY | $549 | — | $549 | 15.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS AND BLUE SHIELD OF MN EIN 41-0984460 ADMINISTRATOR | Other fees; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $1.1M |
| DDMN ASO, LLC EIN 41-1905554 DENTAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $65K |
| INTERFLEX PAYMENTS, LLC EIN 27-2256926 FSA ADMINISTRATOR | Contract Administrator Service code 13 | — | $28K |
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 | 2,554 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 49 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,603 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 4,527 | $3.5M |
| Vision | EYEMED VISION CARE | 4,009 | $314K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,554 | $1.2M |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,946 | $244K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 2,527 | $351K |
| Other(3 contracts, 3 carriers) | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | 2,110 | $138K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 4,527 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.