| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHAEL KLEPATZ3 | 150 EAST 4TH PLACE, SUITE 306 SIOUX FALLS, SD 57104 | DELTA DENTAL OF SOUTH DAKOTA | $3K | — | $3K | 1.31% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES, MURPHY & ASSOCIATES, INC | 13810 FNB PARKWAY, SUITE 300 OMAHA, NE 68154 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| AVANT SPECIALTY BENEFITS LLC3 Filed as: AVANT SPECIALTY BENEFITS, LLC | 1828 WALNUT STREET, SUITE 801 KANSAS CITY, MO 64108 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $576 | $576 | 2.00% |
| HOLMES MURPHY & ASSOCIATES3 Filed as: HOLMES MURPHY & ASSOCIATES LLC | 2727 GRAND PRAIRIE PARKWAY WAUKEE, IA 50263 | COMPANION LIFE INSURANCE COMPANY | $977 | $0 | $977 | 13.42% |
| DAKOTACARE ADMINISTRATIVE SERVICES3 | PO BOX 7406 SIOUX FALLS, SD 57117 | COMPANION LIFE INSURANCE COMPANY | $488 | $0 | $488 | 6.70% |
| SUMMIT REINSURANCE SERVICES INC3 Filed as: SUMMIT REINSURANCE SERVICES | 7030 POINTE INVERNESS WAY SUITE 350 FORT WAYNE, IN 46804 | COMPANION LIFE INSURANCE COMPANY | $146 | — | $146 | 2.00% |
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 | 247 | 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) | 247 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 388 | $255K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 285 | $29K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 222 | $7K |
| Other | COMPANION LIFE INSURANCE COMPANY | 222 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 388 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.