| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | — | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $26K | — | $26K | 2.40% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 2290 LUCIEN WAY MAITLAND, FL 32751 | DELTA DENTAL OF MINNESOTA | $3K | — | $3K | 1.68% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC--LARA PISCHKE | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF MINNESOTA | $3K | — | $3K | 1.66% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 901 MARQUETTE AVENUE SUITE 1800 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF MINNESOTA | $3K | — | $3K | 1.65% |
| AMBER MUSKE3 Filed as: AMBER N MUSKE | 11769 31ST STREET SOUTHEAST VALLEY CITY, ND 58072 | CONTINENTAL AMERICAN INSURANCE COMPANY | $6K | — | $6K | 10.72% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 655 NORTH FRANKLIN STREET SUITE 1900 TAMPA, FL 33602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | — | $3K | 5.93% |
| THOMAS J CASSADY3 Filed as: THOMAS JOHN CASSADY | 1102 5TH STREET SOUTH FARGO, ND 58103 | CONTINENTAL AMERICAN INSURANCE COMPANY | $598 | — | $598 | 1.15% |
| SHAWN D BENSER3 Filed as: SHAWN DUNN BENSER | 214 PARK DRIVE HARWOOD, ND 58042 | CONTINENTAL AMERICAN INSURANCE COMPANY | $289 | — | $289 | 0.56% |
| MICHELE A HREN3 | 145 MONTROSE PLACE SAINT PAUL, MN 55104 | CONTINENTAL AMERICAN INSURANCE COMPANY | $35 | — | $35 | 0.07% |
| JOLYNNE M MACK3 | 1301 4TH STREET NORTHEAST WATERTOWN, SD 57201 | CONTINENTAL AMERICAN INSURANCE COMPANY | $19 | — | $19 | 0.04% |
| BRADY L WEISENBERGER3 | 4553 9TH AVENUE SOUTH #3 FARGO, ND 58103 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | RELIASTAR LIFE INSURANCE COMPANY | $4K | — | $4K | 8.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 NORTH MAYFAIR ROAD SUITE 1001200N MILWAUKEE, WI 53226 | RELIASTAR LIFE INSURANCE COMPANY | $3K | — | $3K | 7.11% |
| WATCHTOWER BENEFITS, LLC3 | 227 WEST MONROE STREET SUITE 5200 CHICAGO, IL 60606 | RELIASTAR LIFE INSURANCE COMPANY | — | $617 | $617 | 1.30% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 SOUTH 8TH STREET IDS CENTER SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| WATCHTOWER TECHNOLOGIES INC3 | 2734 NORTH MILDRED AVENUE #3 CHICAGO, IL 60614 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $636 | $636 | 1.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $411 | $411 | 0.97% |
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 | 287 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 297 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MINNESOTA | 347 | $184K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 416 | $20K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 287 | $48K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 269 | $42K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 465 | $1.1M |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 287 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 465 | — |
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."
No prospect flags tripped on this filing.