| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SEVENHILLS BENEFIT PARTNERS3 Filed as: SEVENHILLS BENEFIT PARTNERES, INC | 345 ST. PETER STREET 2040 LANDMARK TOWERS ST. PAUL, MN 55102 | PREFERREDONE | $19K | — | $19K | 4.16% |
| CORPORATE HEALTH SYSTEMS INC3 | 15153 TECHNOLOGY DRIVE SUITE B EDEN PRAIRIE, MN 553442221 | RELISTAR LIFE INSURANCE COMPANY | $35K | — | $35K | 7.74% |
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS PARTNERS, INC. | 345 SAINT PETER STREET 2040 LANDMARK TOWERS SAINT PAUL, MN 551021211 | RELISTAR LIFE INSURANCE COMPANY | $34K | — | $34K | 7.50% |
| PREFERREDONE ADMINISTRATIVE SERVICE3 | 6105 GOLDEN HILLS DR GOLDEN VALLEY, MN 554161023 | RELISTAR LIFE INSURANCE COMPANY | — | $5K | $5K | 1.00% |
| SEVENHILLS BENEFIT PARTNERS3 | 345 ST PETER ST 2040 LANDMARK TOWER ST PAUL, MN 55102 | MINNESOTA LIFE INSURANCE COMPANY | $19K | $0 | $19K | 10.60% |
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS PARTNERS INC | 345 ST PETER ST 2040 LANDMARK TOWERS SAINT PAUL, MN 55102 | STANDARD INSURANCE COMPANY | $16K | — | $16K | 19.55% |
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS PARTNERS INC | 345 ST PETER ST 2040 LANDMARK TOWERS SAINT PAUL, MN 55102 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 12.94% |
| SEVENHILLS CLEVELAND LLC3 Filed as: SEVENHILLS PARTNERS INC | 345 ST PETER ST 2040 LANDMARK TOWERS SAINT PAUL, MN 55102 | STANDARD INSURANCE COMPANY | $9K | — | $9K | 19.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL OF MINNESOTA EIN 41-1905554 N/A | Claims processing Service code 12 | — | $0 |
| PREFERREDONE RECORDKEEPER | Claims processing Service code 12 | 6105 GOLDEN HILLS DRIVE GOLDEN VALLEY, MN 554161025 | $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 | 310 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(3 contracts, 3 carriers) | MINNESOTA LIFE INSURANCE COMPANY | 687 | $240K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 286 | $47K |
| Long-term disability | STANDARD INSURANCE COMPANY | 473 | $81K |
| Stop-loss / reinsurancereinsurance | PREFERREDONE | 555 | $453K |
| Other | RELISTAR LIFE INSURANCE COMPANY | 311 | $453K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 687 | — |
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.