| 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 | $20K | — | $20K | 2.00% |
| SASHA CAMPBELL3 | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $5K | $21 | $5K | 6.81% |
| THOMAS D CASSADY3 Filed as: THOMAS CASSADY | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $2K | $10 | $2K | 2.30% |
| TAMMY L SCOTT3 | 3700 RUEMMELE RD APT 200 GRAND FORKS, ND 58201 | AFLAC | $2K | — | $2K | 1.90% |
| KEITH OLSON3 Filed as: KEITH A OLSON | 427 31ST AVE E WEST FARGO, ND 58078 | AFLAC | $935 | $31 | $966 | 1.21% |
| SHAWN D BENSER3 | 4840 AMBER VALLEY PKWY S STE C FARGO, ND 58104 | AFLAC | $774 | — | $774 | 0.97% |
| VICTORIA AMBER BENTZ3 | 4233 39TH AVE S FARGO, ND 58104 | AFLAC | $432 | — | $432 | 0.54% |
| LAWRENCE R ZAHRADKA3 | 2750 GATEWAY DR STE D GRAND FORKS, ND 58203 | AFLAC | $343 | — | $343 | 0.43% |
| AMBER MUSKE3 | 11769 31ST ST SE VALLEY CITY, ND 58072 | AFLAC | $244 | — | $244 | 0.31% |
| KATRINA REINKE3 | 1503 6TH AVE N WAHPETON, ND 58075 | AFLAC | $130 | — | $130 | 0.16% |
| ANDREW C MJONESS3 | 2917 14TH AVE S MOORHEAD, MN 56560 | AFLAC | $71 | — | $71 | 0.09% |
| SLOANE MUEHLER3 | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $68 | — | $68 | 0.09% |
| KIRK MOTL3 | 3101 LONGBOW CT GRAND FORKS, ND 58203 | AFLAC | $40 | — | $40 | 0.05% |
| GREG LITZ3 | 10 S 3RD ST GRAND FORKS, ND 58201 | AFLAC | $39 | — | $39 | 0.05% |
| BRIAN D DORFF3 Filed as: BRIAN DORFF | 9194 32ND AVE S GRAND FORKS, ND 58201 | AFLAC | $38 | — | $38 | 0.05% |
| JOHN L ANDERSON3 | 3334 2ND ST E WEST FARGO, ND 58078 | AFLAC | $38 | — | $38 | 0.05% |
| MICHAEL HUNTER LECKNER3 | 3846 12TH ST W WEST FARGO, ND 58078 | AFLAC | $25 | — | $25 | 0.03% |
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 | 112 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 158 | $992K |
| Dental | AFLAC | 85 | $80K |
| Vision | AFLAC | 85 | $80K |
| Life insurance | AFLAC | 85 | $80K |
| Short-term disability | AFLAC | 85 | $80K |
| Other | AFLAC | 85 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 158 | — |
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.