| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PINNACLE BROKERS3 Filed as: PINNACLE EMPLOYEE BENEFITS LLC | 710 31ST AVENUE SW, SUITE 3 MINOT, ND 58701 | SANFORD HEALTH PLAN | $8K | $0 | $8K | 1.92% |
| LOARD AGENCY INC3 | 1520 69TH STREET NW MINOT, ND 58703 | AFLAC | $4K | $0 | $4K | 4.20% |
| MJ INSURANCE3 Filed as: SHELBY BARSTAD AND VARIOUS AGENTS | PO BOX 345 VELVA, ND 58790 | AFLAC | $2K | $0 | $2K | 1.81% |
| LEANNE R PETERSON3 Filed as: LEANNE R. PETERSON | 603 STEVENSON STREET NW BERTHOLD, ND 58718 | AFLAC | $1K | $0 | $1K | 1.63% |
| JANEL FUCHS3 Filed as: JANEL K. FUCHS | 516 7TH AVENUE SE MINOT, ND 58701 | AFLAC | $1K | $0 | $1K | 1.51% |
| GENIEL M. VEDAA3 | PO BOX 550 VELVA, ND 58790 | AFLAC | $1K | $0 | $1K | 1.21% |
| KIMBERLY J WELSTAD3 Filed as: KIMBERLY J. WELSTAD | 1513 COOK DRIVE MINOT, ND 58701 | AFLAC | $628 | $0 | $628 | 0.72% |
| CYNTHIA D WELKEN-PLACE3 Filed as: CYNTHIA D. PLACE | 601 CODY DRIVE BISMARCK, ND 58503 | AFLAC | $620 | $0 | $620 | 0.71% |
| TAWNIA HEILMAN3 Filed as: TAWNIA M. HEILMAN | 228 DAKOTA STREET HARVEY, ND 58341 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 7.11% |
| PINNACLE BROKERS3 Filed as: PINNACLE EMPLOYEE BENEFITS LLC | 710 31ST AVENUE SW, SUITE 3 MINOT, ND 58701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $445 | $24 | $469 | 2.09% |
| PINNACLE BROKERS3 Filed as: PINNACLE EMPLOYEE BENEFITS LLC | 710 31ST AVENUE SW, SUITE 3 MINOT, ND 58701 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $267 | $2K | 18.49% |
| MARC A GROVE3 Filed as: MARC A. GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $669 | $0 | $669 | 5.00% |
| TAWNIA HEILMAN3 Filed as: TAWNIA M. HEILMAN | 228 DAKOTA STREET HARVEY, ND 58341 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $0 | $1K | 16.98% |
| LOARD AGENCY INC3 | 1520 69TH STREET NW MINOT, ND 58703 | AFLAC | $415 | $0 | $415 | 7.32% |
| GENIEL M. VEDAA3 | PO BOX 550 VELVA, ND 58790 | AFLAC | $94 | $0 | $94 | 1.66% |
| LEANNE R PETERSON3 Filed as: LEANNE R. PETERSON | 603 STEVENSON STREET NW BERTHOLD, ND 58718 | AFLAC | $88 | $0 | $88 | 1.55% |
| KIMBERLY J WELSTAD3 Filed as: KIMBERLY J. WELSTAD | 1513 COOK DRIVE MINOT, ND 58701 | AFLAC | $87 | $0 | $87 | 1.53% |
| CYNTHIA D WELKEN-PLACE3 Filed as: CYNTHIA D. PLACE | 601 CODY DRIVE BISMARCK, ND 58503 | AFLAC | $49 | $0 | $49 | 0.86% |
| MJ INSURANCE3 Filed as: BROOKE HANSEN AND VARIOUS AGENTS | 315 23RD TER E WILLISTON, ND 58801 | AFLAC | $44 | $0 | $44 | 0.78% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL J. TOMLINSON | 40 PARADISE DRIVE WATERTOWN, SD 57201 | AFLAC | $17 | $0 | $17 | 0.30% |
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 | 151 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 152 | 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 | 151 | $1.0M |
| Dental(2 contracts) | AFLAC | 72 | $93K |
| Vision(2 contracts) | AFLAC | 72 | $93K |
| Life insurance(5 contracts, 3 carriers) | AFLAC | 151 | $135K |
| Short-term disability(2 contracts) | AFLAC | 72 | $93K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 142 | $22K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 151 | $1.0M |
| Other(6 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 151 | $1.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.