| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP, INC. | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | GUARDIAN | $15K | — | $15K | 8.67% |
| ENROLLEASE3 | 660 YORK ST STE 102 SAN FRANCISCO, CA 94110 | GUARDIAN | $5K | — | $5K | 3.00% |
| CHRISTENSEN GROUP INC3 Filed as: CHRISTENSEN GROUP, INC | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | EYEMED VISION CARE | $2K | — | $2K | 9.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MEDICA INSURANCE COMPANY 41-1479417 | Claims processing; Contract Administrator Service code 12 | — | $152K |
| CHRISTENSEN GROUP INC 41-0873705 | Insurance agents and brokers Service code 22 | — | $97K |
| MEDICA INSURANCE COMPANY EIN 41-1479417 CLAIM PROCESSING | Claims processing; Contract Administrator Service code 12 | — | $34K |
| DDMN ASO, LLC EIN 41-1852523 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $10K |
| CHRISTENSEN GROUP, INC. AGENT/AGENCY | Insurance agents and brokers Service code 22 | 9855 W 78TH ST STE 100 EDEN PRAIRIE, MN 55344 | $7K |
| CHRISTENSEN GROUP INC EIN 41-0873705 AGENT | Insurance agents and brokers Service code 22 | — | $0 |
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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 151 | $319K |
| Vision | EYEMED VISION CARE | 125 | $22K |
| Life insurance | GUARDIAN | 195 | $168K |
| Short-term disability | GUARDIAN | 195 | $168K |
| Long-term disability | GUARDIAN | 195 | $168K |
| Stop-loss / reinsurancereinsurance | MEDICA INSURANCE COMPANY | 151 | $319K |
| Other | GUARDIAN | 195 | $168K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 195 | — |
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."
No prospect flags tripped on this filing.