| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $9K | $101 | $9K | 10.24% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $6K | $6K | 6.33% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMNSTRS INC | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $5K | $5K | 5.33% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $802 | $802 | 0.90% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $6K | — | $6K | 18.47% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 6.15% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMNSRS INC | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $2K | $2K | 5.29% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $570 | $570 | 1.74% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58107 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 18.49% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 6.16% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON CHAPMAN BNFT ADMNSRS INC | PO BOX 9201 AUSTIN, TX 78766 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $1K | $1K | 5.29% |
| MARK S METTILLE3 | 422 WAUPONSEE ST MORRIS, IL 60450 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | — | $366 | $366 | 1.91% |
| HALVORSON BENEFITS PLUS INC3 | PO BOX 2125 FARGO, ND 58103 | MONY LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 24.48% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | MONY LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 10.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF ND EIN 45-0173185 | Contract Administrator Service code 13 | — | $111K |
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 | 146 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 147 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 202 | $1.1M |
| Dental | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 87 | $90K |
| Life insurance | MONY LIFE INSURANCE COMPANY OF AMERICA | 158 | $13K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $33K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $19K |
| Other | MONY LIFE INSURANCE COMPANY OF AMERICA | 158 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 202 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.