| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WOLLMAN INSURANCE AGENCY INC.3 | 2900 S PHILLIPS AVE, STE 100 SIOUX FALLS, SD 57105 | AVERA HEALTH PLANS, INC. | $68K | — | $68K | 1.77% |
| WOLLMAN INSURANCE AGENCY INC.3 | 2900 S PHILLIPS AVE, STE 100 SIOUX FALLS, SD 57105 | DELTA DENTAL OF SOUTH DAKOTA | $2K | — | $2K | 1.40% |
| WOLLMAN INSURANCE AGENCY INC.3 | 2900 S PHILLIPS AVE, STE 100 SIOUX FALLS, SD 57105 | HARTFORD LIFE AND ACCIDENT | $15K | — | $15K | 13.43% |
| BENEUSA LLC3 | 1851 LAKE DR WEST, STE 350 CHANHASSEN, MN 55317 | HARTFORD LIFE AND ACCIDENT | — | $3K | $3K | 2.84% |
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 | 901 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 904 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AVERA HEALTH PLANS, INC. | 1,253 | $3.8M |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 766 | $164K |
| Vision | AVERA HEALTH PLANS, INC. | 1,253 | $3.8M |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 901 | $112K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 901 | $112K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 901 | $112K |
| Prescription drug | AVERA HEALTH PLANS, INC. | 1,253 | $3.8M |
| Other | HARTFORD LIFE AND ACCIDENT | 901 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,253 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.