| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREATER INSURANCE SERVICE3 | 407 SOUTH POKEGAMA AVENUE GRAND RAPIDS, MN 55744 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 3.91% |
| GREATER INSURANCE SERVICE3 | 407 SOUTH POKEGAMA AVENUE GRAND RAPIDS, MN 55744 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17K | — | $17K | 15.00% |
| GROVE, MARC, A3 | 25900 AUTUMN WAY ROGERS, MN 55374 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 13.44% |
| GREATER INSURANCE SERVICE3 | 407 SOUTH POKEGAMA AVENUE GRAND RAPIDS, MN 55744 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.23% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | 401 SOUTH MOUNT JULIET, SUITE 235 PMB 184 MT. JULIET, TN 37076 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $265 | $265 | 1.01% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY ROAD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $122 | — | $122 | 0.46% |
| GROVE, MARC, A3 | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 7.10% |
| GREATER INSURANCE SERVICE3 | 407 SOUTH POKEGAMA AVENUE GRAND RAPIDS, MN 55744 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $515 | — | $515 | 3.16% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | 401 SOUTH MOUNT JULIET, SUITE 235 PMB 184 MT. JULIET, TN 37076 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $115 | $115 | 0.70% |
| SMITH, THOMAS, CHRISTOPHER3 | PO BOX 40386 798 BERRY ROAD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $18 | — | $18 | 0.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICA SELF-INSURED EIN 41-1479417 CLAIMS PROCESSING | Claims processing Service code 12 | — | $470K |
| DDMN ASO, LLC EIN 41-1852523 BENEFIT ADMINISTRATOR | Claims processing; Contract Administrator Service code 12 | — | $26K |
| OPTUMINSIGHT, INC. EIN 41-1858498 CLAIMS PROCESSING | Claims processing Service code 12 | — | $7K |
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 | 488 | 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) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $322K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $205K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $179K |
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 974 | $1.1M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 488 | $312K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 974 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.