| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA Filed as: BLUE CROSS BLUE SHIELD OF ND | 4510 13TH AVE S FARGO, ND 58121 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | — | $911K | $911K | 28.24% |
| BLUE CROSS BLUE SHIELD OF FLORIDA Filed as: BLUE CROSS BLUE SHIELD OF ND | 4510 13TH AVE S FARGO, ND 58121 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | — | $487K | $487K | 19.92% |
| BLUE CROSS BLUE SHIELD OF FLORIDA Filed as: BLUE CROSS BLUE SHIELD OF ND | 4510 13TH AVE S FARGO, ND 58121 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | — | $58K | $58K | 37.84% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BANK OF THE WEST EIN 95-6036451 TRUSTEE | Investment management fees paid indirectly by plan; Trustee (bank, trust company, or similar financial institution); Securities brokerage commissions and fees; Investment management; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 15 | PO BOX 60078 SC-XRD-3W-K LOS ANGELES, CA 90060 | $163K |
| PRIME THERAPEUTICS EIN 26-0076803 | Other fees Service code 99 | 1305 CORPORATE CENTER DRIVE EAGAN, MN 55121 | $0 |
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 | 546 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 546 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Stop-loss / reinsurancereinsurance(3 contracts) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 3,511 | $5.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,511 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.