| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WARNER & COMPANY | 318 BOARDWAY BOX 1470 FARGO, ND 58107 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $7K | — | $7K | 0.57% |
| PREMIER BENEFITS GROUP INC3 Filed as: PREMIER BENEFITS GROUP INC. | 417 MAIN AVE FARGO, ND 58103 | MUTUAL OF OMAHA - UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $5K | $14K | 12.25% |
| PRAIRIE BENEFITS INC. | 417 MAIN AVE FARGO, ND 58103 | ALLSTATE | $15K | — | $15K | 17.97% |
| BECKY COSTE | PO BOX 23 FARGO, ND 58107 | ALLSTATE | $60 | — | $60 | 0.07% |
| WILLIAM FLICKINGER | 2830 NORTH BROOKFIELD ROAD BROOKFIELD, WI 53045 | ALLSTATE | $34 | — | $34 | 0.04% |
| PREMIER BENEFITS GROUP INC3 Filed as: PREMIER BENEFITS GROUP INC. | 417 MAIN AVE FARGO, ND 58103 | MUTUAL OF OMAHA - UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | $3K | $11K | 20.07% |
| PREMIER BENEFITS GROUP INC Filed as: PREMIER BENEFITS GROUP, INC | 417 MAIN AVE FARGO, ND 58103 | AVESIS - FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 7.76% |
| EE DORSETT ASSOCIATES Filed as: EE DORSETT & ASSOCIATES | PO BOX 3006 FARGO, ND 58108 | AVESIS - FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 3.88% |
| PREMIER BENEFITS GROUP INC3 Filed as: PREMIER BENEFITS GROUP INC. | 417 MAIN AVE FARGO, ND 58103 | MUTUAL OF OMAHA - UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $904 | $3K | 14.80% |
| PREMIER BENEFITS GROUP INC3 Filed as: PREMIER BENEFITS GROUP, INC | 417 MAIN AVE FARGO, ND 58103 | STANDARD INSURANCE COMPANY | $858 | — | $858 | 9.16% |
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 | 637 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 637 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 752 | $1.3M |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 752 | $1.3M |
| Vision(2 contracts, 2 carriers) | AVESIS - FIDELITY SECURITY LIFE INSURANCE COMPANY | 395 | $50K |
| Life insurance(2 contracts) | MUTUAL OF OMAHA - UNITED OF OMAHA LIFE INSURANCE COMPANY | 540 | $73K |
| Long-term disability | MUTUAL OF OMAHA - UNITED OF OMAHA LIFE INSURANCE COMPANY | 541 | $115K |
| Other(2 contracts) | MUTUAL OF OMAHA - UNITED OF OMAHA LIFE INSURANCE COMPANY | 540 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 752 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.