| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | MEDICA INSURANCE COMPANY | $23K | $0 | $23K | 2.68% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE BLOOMINGTON, MN 55437 | MEDICA INSURANCE COMPANY | $11K | $2K | $13K | 1.53% |
| VARNEY & COMPANY BENEFITS ADVISORS3 Filed as: USE INSURANCE SERVICES, LLC | 3618 HAZELMOOR PLACE MINNETONKA, MN 55345 | PROVIDENCE HEALTH GROUP | $8K | $0 | $8K | 1.53% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | PROVIDENCE HEALTH GROUP | $6K | $0 | $6K | 1.15% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | DELTA DENTAL OF MINNESOTA | $6K | $0 | $6K | 5.82% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | DELTA DENTAL OF MINNESOTA | $3K | $0 | $3K | 3.29% |
| LOCKTON COMPANIES, LLC3 | 5500 WAYZATA BOULEVARD, SUITE 510 MINNEAPOLIS, MN 55416 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | $0 | $10K | 13.77% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $146 | $0 | $146 | 0.19% |
| LOCKTON COMPANIES, LLC3 | PO BOX 843844 KANSAS CITY, MO 64184 | VISION SERVICE PLAN | $1K | $0 | $1K | 10.05% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | $1K | $0 | $1K | 8.25% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KPD INSURANCE, INC. | PO BOX 784 SPRINGFIELD, OR 97477 | VISION SERVICE PLAN | -$170 | $0 | -$170 | -1.37% |
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 | 147 | 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) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | MEDICA INSURANCE COMPANY | 101 | $1.4M |
| Dental | DELTA DENTAL OF MINNESOTA | 213 | $106K |
| Vision | VISION SERVICE PLAN | 105 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 228 | $76K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 228 | $76K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 228 | $76K |
| Prescription drug | MEDICA INSURANCE COMPANY | 101 | $842K |
| Other(3 contracts, 3 carriers) | PROVIDENCE HEALTH GROUP | 228 | $609K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.