| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 580 NORTH 4TH STREET, SUITE 400 COLUMBUS, OH 43215 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 3.20% |
| USI INSURANCE SERVICES LLC3 | 4300 MARKET POINTE DRIVE, SUITE 600 BLOOMINGTON, MN 55435 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $0 | $6K | 10.39% |
| USI INSURANCE SERVICES LLC3 | 400 HIGHWAY 169 SOUTH SUITE 800 MINNEAPOLIS, MN 55426 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $772 | $1K | $2K | 3.09% |
| USI INSURANCE SERVICES LLC3 | 400 HIGHWAY 169 SOUTH SUITE 800 MINNEAPOLIS, MN 55426 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $275 | $0 | $275 | 3.19% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $207 | $1 | $208 | 2.41% |
| ELIZABETH MARIE LANGEVIN3 | 698 WEST LARPENTEUR AVENUE SAINT PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $79 | $0 | $79 | 0.92% |
| JILL R LAMBERT Filed as: JILL R. LAMBERT | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $76 | $0 | $76 | 0.88% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $44 | $0 | $44 | 0.51% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $35 | $0 | $35 | 0.41% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INS. INC. AND VARIOUS AGENTS | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $13 | $2 | $15 | 0.17% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $463 | $0 | $463 | 9.54% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INS. INC. AND VARIOUS AGENTS | 3357 POLK STREET NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $190 | $38 | $228 | 4.70% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $144 | $43 | $187 | 3.85% |
| MICHELL J. HALLER3 | 913 HUNTINGON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $86 | $83 | $169 | 3.48% |
| MJ INSURANCE3 Filed as: JILL R. LAMBERT AND VARIOUS AGENTS | 12741 JEFFERSON STREET NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $92 | $12 | $104 | 2.14% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $12 | $48 | 0.99% |
| CARRIE S FLATEN3 Filed as: CARRIE S. FLATEN | 2606 86TH COURT WEST NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $23 | $2 | $25 | 0.52% |
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 | 224 | 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) | 224 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 106 | $118K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 224 | $58K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 224 | $58K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 224 | $71K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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.