| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORTH RISK PARTNERS LLC3 Filed as: NORTH RISK PARTNERS MENDOTA | 622 ROOSEVELT RD STE 240 ST. CLOUD, MN 56301 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | — | $11K | 12.01% |
| NORTH RISK PARTNERS LLC3 Filed as: NORTH RISK PARTNERS, LLC | 10405 6TH AVE N STE 300 PLYMOUTH, MN 55441 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 2.00% |
| NORTH RISK PARTNERS LLC3 | 622 ROOSEVELT RD STE 240 SAINT CLOUD, MN 56301 | PRINCIPAL LIFE INSURANCE COMPANY | $7K | $2K | $9K | 12.71% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 1787 SENTRY PKWY W STE 320 BLUE BELL, PA 19422 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $4K | $4K | 6.17% |
| NORTH RISK PARTNERS LLC3 Filed as: NORTH RISK PARTNERS MENDOTA | 622 ROOSEVELT RD STE 240 ST. CLOUD, MN 56301 | STARMOUNT LIFE INSURANCE COMPANY | $1K | — | $1K | 12.01% |
| NORTH RISK PARTNERS LLC3 Filed as: NORTH RISK PARTNERS, LLC | 10405 6TH AVE N STE 300 PLYMOUTH, MN 55441 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $190 | $190 | 2.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $67K |
| OPTUM RX INC. EIN 33-0441200 PHARMACY BENEFIT MANAGEM | Claims processing; Float revenue; Direct payment from the plan; Other fees Service code 12 | — | $35K |
| NORTH RISK PARTNERS LLC EIN 46-1375576 BROKER | Other commissions Service code 55 | 8204 S 109TH STREET LA VIST, NE 68128 | $20K |
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 | 113 | 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) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 153 | $69K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 114 | $9K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $90K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $90K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $90K |
| Stop-loss / reinsurancereinsurance(3 contracts) | TPAC-SPAGGREGATE-PAN AM LIFE | 40 | $276K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 131 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 153 | — |
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.