| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 | 6160 GOLDEN HILLS DRIVE GOLDEN VALLEY, MN 55416 | PREFERREDONE INSURANCE COMPANY | $22K | $0 | $22K | 2.00% |
| LAMPHERE INS GROUP3 | 606 25TH AVE S STE 204 ST. CLOUD, MN 56301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $0 | $14K | 11.84% |
| LAMPHERE INSURANCE GROUP LLC3 | 606 25TH AVE SOUTH STE 204 SAINT CLOUD, MN 56303 | DELTA DENTAL OF MINNESOTA | $3K | $0 | $3K | 2.86% |
| GCG FINANCIAL LLC3 Filed as: DIRECT BENEFITS AN ALERA GROUP AGEN | 55 5TH ST E STE 500 SAINT PAUL, MN 55101 | DELTA DENTAL OF MINNESOTA | $2K | $0 | $2K | 1.43% |
| BLUE CHIP FINANCIAL INC3 | 49 2ND AVE N STE 101 WAITE PARK, MN 56387 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $290 | $0 | $290 | 3.14% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $217 | $4 | $221 | 2.40% |
| ASHLEY MARIA HOUTMAN3 | ASHLEY MARIA HOUTMAN MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $160 | $7 | $167 | 1.81% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $92 | $10 | $102 | 1.11% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $41 | $1 | $42 | 0.46% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DRIVE RUSH CITY, MN 55069 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $40 | $1 | $41 | 0.44% |
| TYLER HERRINGTON TORBETT3 Filed as: TYLER JAMES JENDRO | 2019 4TH AVE N APT 202 SAUK RAPIDS, MN 56379 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 0.38% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.09% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.01% |
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 | 150 | 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) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | PREFERREDONE INSURANCE COMPANY | 277 | $1.1M |
| Dental | DELTA DENTAL OF MINNESOTA | 428 | $118K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $121K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $121K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $121K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 140 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 428 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.