| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| INTELLICENTS INC3 | 201 E CLARK ST ALBERT LEA, MN 56007 | AFLAC | $5K | — | $5K | 18.38% |
| HEIDI ALFSON3 | 602 IRONWOOD DR HARTFORD, SD 57033 | AFLAC | $3K | — | $3K | 10.47% |
| ERIC PALMER3 | 114 N MAIN ST MITCHELL, SD 57301 | AFLAC | $3K | — | $3K | 10.20% |
| ASHTON L CONNELL3 | 1204 E 3RD AVE MITCHELL, SD 57301 | AFLAC | $469 | — | $469 | 1.62% |
| ASHLEY D WARNER3 | 712 2ND ST SW DE SMET, SD 57231 | AFLAC | $103 | — | $103 | 0.35% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN EIN 41-0984460 | Contract Administrator; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 12 | — | $42K |
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 | 189 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 189 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BCBSMN, INC DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 128 | $143K |
| Life insurance | ASSURANT | 189 | $0 |
| Long-term disability | ASSURANT | 189 | $0 |
| Other | AFLAC | 54 | $29K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.