| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: PHILLIP BROWN | PO BOX 1898 FARGO, ND 581071898 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.21% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: PHILLIP BROWN | 32314 LOON DRIVE VERGAS, MN 56587 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.26% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 581072125 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $691 | — | $691 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ND EIN 45-0173185 | Contract Administrator Service code 13 | — | $158K |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 3 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 145 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 179 | $1.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 146 | $68K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $14K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $56K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 138 | $56K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 132 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 179 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
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.