Form 5500 · Employee benefit plan · BAYPORT, MN
ANDERSEN CORPORATION
The filing calls this plan ANDERSEN CORPORATION RETIREE MEDICAL PLAN.
ANDERSEN CORPORATION of BAYPORT, MN files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Coverage is written through MINNESOTA LIFE INSURANCE COMPANY and 1 other carrier. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 41-0123208 · plan 511 · plan year 2025, filed Jul 24, 2026
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How this plan is funded
Self-funded as reported
The filing reports benefits paid from the plan's own money, and no medical insurance contract on Schedule A.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering life and stop-loss; the largest, with MINNESOTA LIFE INSURANCE COMPANY, covers 676 people.
The filing declares health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The stop-loss contract reports $25,256 in premium and $0 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.
Reported premium is $6,851,499; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| MINNESOTA LIFE INSURANCE COMPANY | Life | 676 | Aug 1, 2025 | $6,826,243 | $0 |
| HEALTHPARTNERS/GROUP HEALTH INC. | Stop-loss | 1,016 | Jan 1, 2026 | $25,256 | $0 |
Premium and claims on this contract
MINNESOTA LIFE INSURANCE COMPANY, contract 50199-G. For the contract year on this filing, the carrier reported $6,826,243 in premium earned and $2,602,724 in claims incurred. Dividing one by the other gives 38%.
- MINNESOTA LIFE INSURANCE COMPANY, contract 50199-G reported $-188,137 in retention.
Retention is what the carrier kept of the premium after claims, as reported: administration, commissions and other charges.
Only experience-rated contracts report these figures, so most filings leave them blank.
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. The service providers are named on Schedule C of this filing. We publish company names only.
Reported to OSHA
Reported to OSHA for 2025: 3,913 employees, 87 recordable cases, 543 days away from work.
Source: OSHA Injury Tracking Application establishment data, 2025.
Money the plan held and paid out
Sourced from U.S. DOL EFAST2 Form 5500 · Schedule H
These are the plan's own figures from Schedule H, the financial statement it files. They are not the premium on Schedule A.
Other plans filed by this employer
How this plan compares
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