| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 580 NORTH FOURTH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 3.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 4300 MARKET POINTE DRIVE, SUITE 600 BLOOMINGTON, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 10.37% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 400 HIGHWAY 169 SOUTH SAINT LOUIS PARK, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $749 | $966 | $2K | 3.11% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | 400 HIGHWAY 169 SOUTH, SUITE 800 MINNEAPOLIS, MN 55426 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $509 | $0 | $509 | 4.21% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $318 | $5 | $323 | 2.67% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR SAINT PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $1 | $89 | 0.74% |
| JILL R LAMBERT3 | 12741 JEFFERSON STREET NORTHEAST BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $87 | $1 | $88 | 0.73% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DRIVE SOUTHEAST SAINT MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 0.63% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN MOFFAT LUCAS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $1 | $56 | 0.46% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $32 | $5 | $37 | 0.31% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH MAIRE LANGEVIN | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 0.29% |
| CARRIE S FLATEN3 | 2606 86TH COURT WEST NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $0 | $23 | 0.19% |
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 | 219 | 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) | 219 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 103 | $107K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 219 | $55K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 219 | $55K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 219 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.