| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| VAALER INSURANCE INC3 | 2701 S COLUMBIA RD GRAND FORKS, ND 58201 | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $17K | — | $17K | 2.00% |
| SASHA CAMPBELL3 | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $3K | $218 | $4K | 5.56% |
| THOMAS D CASSADY3 Filed as: THOMAS CASSADY | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $2K | $81 | $2K | 2.88% |
| SHAWN D BENSER3 | 4840 AMBER VALLEY PKWY S STE C FARGO, ND 58103 | AFLAC | $1K | $60 | $1K | 2.16% |
| AMBER MUSKE3 | 11769 31ST ST SE VALLEY CITY, ND 58072 | AFLAC | $1K | $57 | $1K | 1.96% |
| JOHN PAUL STROH3 | 3230 SETER PKWY S APT 220 FARGO, ND 58104 | AFLAC | $966 | $43 | $1K | 1.53% |
| KATRINA REINKE3 | 1503 6TH AVE N WAHPETON, ND 58075 | AFLAC | $943 | — | $943 | 1.43% |
| LAWRENCE R ZAHRADKA3 Filed as: LAWRENCE ZAHRADKA | 10 S 3RD ST GRAND FORKS, ND 58201 | AFLAC | $287 | — | $287 | 0.43% |
| ANDREW C MJONESS3 | 2917 14TH AVE S MOORHEAD, MN 56560 | AFLAC | $85 | — | $85 | 0.13% |
| SLOANE MUEHLER3 | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $68 | — | $68 | 0.10% |
| KEITH OLSON3 Filed as: KEITH A OLSON | 427 31ST AVE E WEST FARGO, ND 58078 | AFLAC | $66 | — | $66 | 0.10% |
| LAWRENCE R ZAHRADKA3 | 2750 GATEWAY DR STE D GRAND FORKS, ND 58203 | AFLAC | $57 | — | $57 | 0.09% |
| KIRK MOTL3 | 3101 LONGBOW CT GRAND FORKS, ND 58203 | AFLAC | $37 | — | $37 | 0.06% |
| GREG LITZ3 | 10 S 3RD ST GRAND FORKS, ND 58201 | AFLAC | $36 | — | $36 | 0.05% |
| BRIAN D DORFF3 Filed as: BRIAN DORFF | 9194 32ND AVE S GRAND FORKS, ND 58201 | AFLAC | $35 | — | $35 | 0.05% |
| MICHAEL HUNTER LECKNER3 | 3846 12TH ST W WEST FARGO, ND 58078 | AFLAC | $6 | — | $6 | 0.01% |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 161 | $862K |
| Dental | AFLAC | 49 | $66K |
| Vision | AFLAC | 49 | $66K |
| Life insurance | AFLAC | 49 | $66K |
| Short-term disability | AFLAC | 49 | $66K |
| Other | AFLAC | 49 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 161 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.