| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $5K | $8K | 18.25% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $2K | $7K | 16.95% |
| MPART BENEFITS INC3 | 100 ALBRIGHT LN PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $338 | $438 | $776 | 1.82% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS LIC | 100 ALBRIGHT LANE PROSPER, TX 75078 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $329 | $292 | $621 | 1.46% |
| TIMOTHY B DONNELLY3 | 5960 92ND AVE N PINELLAS PARK, FL 33782 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $494 | $12 | $506 | 1.19% |
| ELIZABETH MARIE LANGEVIN3 | 51685 BELLE ISLE DR RUSH CITY, MN 55069 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $225 | $0 | $225 | 0.53% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $90 | $0 | $90 | 0.21% |
| COACH CONCEPTS INC3 | 4750 HURON ROAD ST PETERSBURG, FL 33708 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $73 | $5 | $78 | 0.18% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $60 | $0 | $60 | 0.14% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $29 | $31 | $60 | 0.14% |
| EDIANNETTE ROSADOFONSECA3 | 842 COUNTRY CROSSING CT KISSIMMEE, FL 34744 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.03% |
| JENNIFER MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $7 | $11 | 0.03% |
| KUHL INSURANCE INC3 | 2031 SHATTO DR DR BELGRADE, MT 59714 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| MS BENEFITS LIC 1003 | CHALLENGER RD STE 400 RIDGEFIELD PARK, NJ 07660 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.01% |
| DAVID J MCCLELLAN3 | 118 ROYAL HORSE WAY REINHOLDS, PA 17569 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $2 | $3 | 0.01% |
| THE MEEHAN AGENCY LLC3 Filed as: THE MEEHAN AGENCY LIC | 1924 DOWN HOLLOW LN WINDERMERE, FL 34786 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| DAWN RENEE MORGAN3 | 6413 DUNMOOR DR PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $0 | $2 | 0.00% |
| HOVIE AGENCY LLC3 Filed as: HOVIE AGENCY LIC | 11261 WRIGHT CIR OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| REBECCA J MERRITT3 | 927 E KEIM DR PHOENIX, AZ 85014 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| JAROLD L WELKER3 | 1922 N 45TH ST PHOENIX, AZ 85008 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| CARRIE S FLATEN3 | 2702 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| PARKS BENEFITS & ENROLLMENT LLC3 Filed as: PARKS BENEFITS & ENROLLMENT | 504 LITCHFIELD LN LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 S 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE C | $2K | $0 | $2K | 6.85% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES IN | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $0 | $2K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $374 | $0 | $374 | 9.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $360 | $0 | $360 | 10.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $92 | $0 | $92 | 9.99% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $49 | $0 | $49 | 10.10% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13 | $0 | $13 | 9.92% |
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 | 239 | 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) | 239 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE C | 285 | $22K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $19K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 62 | $43K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 10 | $4K |
| Other(4 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 237 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 285 | — |
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.