| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 400 BLOOMINGTON, MN 55437 | SANFORD HEALTH PLAN | $16K | $0 | $16K | 2.29% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $197 | $2K | 5.19% |
| MIKE ANDERSON3 | 529 4TH AVENUE NE REYNOLDS, ND 58275 | US ALLIANCE LIFE AND SECURITY COMPANY | $1K | $0 | $1K | 7.15% |
| US ALLIANCE MARKETING CORPORATION3 | 1303 SW FIRST AMERICAN PIACE SUITE 200 TOPEKA, KS 66604 | US ALLIANCE LIFE AND SECURITY COMPANY | $279 | $0 | $279 | 1.66% |
| MIKE WEDERSKI3 | 1303 SW FIRST AMERICAN PLACE SUITE 200 TOPEKA, KS 66604 | US ALLIANCE LIFE AND SECURITY COMPANY | $190 | $0 | $190 | 1.13% |
| BILL LEIER3 | 320 32ND AVENUE WEST, SUITE 302 WEST FARGO, ND 58078 | US ALLIANCE LIFE AND SECURITY COMPANY | $96 | $0 | $96 | 0.57% |
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 | 126 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SANFORD HEALTH PLAN | 45 | $677K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 29 | $31K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 29 | $31K |
| Life insurance | US ALLIANCE LIFE AND SECURITY COMPANY | 126 | $17K |
| Prescription drug | SANFORD HEALTH PLAN | 45 | $677K |
| Other | US ALLIANCE LIFE AND SECURITY COMPANY | 126 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.