| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | — | $19K | $19K | 1.87% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | STARMOUNT LIFE INSURANCE | $5K | — | $5K | 8.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | STARMOUNT LIFE INSURANCE | — | $4K | $4K | 5.41% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC. | PO BOX 9201 AUSTIN, TX 78766 | STARMOUNT LIFE INSURANCE | $3K | — | $3K | 4.12% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 5.36% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 4.00% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 10.00% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $951 | $951 | 5.38% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $707 | — | $707 | 4.00% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | 318 BROADWAY PO BOX 1470 FARGO, ND 58102 | TRANSAMERICA LIFE INSURANCE COMPANY | $874 | — | $874 | 5.76% |
| HALVORSON BENEFITS PLUS INC3 Filed as: HALVORSON BENEFITSPLUS INC | 3320 WESTRAC DR S FARGO, ND 58103 | TRANSAMERICA LIFE INSURANCE COMPANY | $415 | — | $415 | 2.74% |
| DIANA LEWIS3 Filed as: DIANA N LEWIS | 28059 US HWY 19 N, STE 201 CLEARWATER, FL 33761 | TRANSAMERICA LIFE INSURANCE COMPANY | $205 | — | $205 | 1.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: ESTATE OF JANICE BROWN | 5260 E MASON LAKE DR W GRAPEVIEW, WA 98546 | TRANSAMERICA LIFE INSURANCE COMPANY | $182 | — | $182 | 1.20% |
| ART JETTER AND COMPANY3 Filed as: ART JETTER & COMPANY | 13624 PARKER CIRCLE OMAHA, NE 68154 | TRANSAMERICA LIFE INSURANCE COMPANY | $135 | — | $135 | 0.89% |
| GEORGE ARNOLD & ASSOCIATES INC3 | PO BOX 469 FARGO, ND 58107 | TRANSAMERICA LIFE INSURANCE COMPANY | $90 | — | $90 | 0.59% |
| SWARTZBAUGH-FARBER & ASSOCIATES INC3 Filed as: SWARTZBAUGH-FARBER & ASSOC INC | 1015 NORTH 98TH STREET SUITE 221 OMAHA, NE 68114 | TRANSAMERICA LIFE INSURANCE COMPANY | $46 | — | $46 | 0.30% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | TRANSAMERICA LIFE INSURANCE COMPANY | $41 | — | $41 | 0.27% |
| BENEPORT LLC3 | 28059 US HWY 19 N STE 201 CLEARWATER, FL 33761 | TRANSAMERICA LIFE INSURANCE COMPANY | $39 | — | $39 | 0.26% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | UNUM INSURANCE COMPANY | $1K | — | $1K | 10.85% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $617 | $617 | 5.41% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM INSURANCE COMPANY | $611 | — | $611 | 5.35% |
| BELL-ANDERSON AGENCY INC3 Filed as: BELL INSURANCE SERVICES LLC | PO BOX 1470 FARGO, ND 58107 | UNUM INSURANCE COMPANY | $925 | — | $925 | 10.95% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS | 422 WAUPONSEE ST MORRIS, IL 60450 | UNUM INSURANCE COMPANY | — | $460 | $460 | 5.45% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN, INC | PO BOX 9201 AUSTIN, TX 78766 | UNUM INSURANCE COMPANY | $457 | — | $457 | 5.41% |
| HALVORSON BENEFITS PLUS INC3 Filed as: HALVORSON BENEFITSPLUS, INC | 3320 WESTRAC DR S FARGO, ND 58103 | TRANSAMERICA LIFE INSURANCE COMPANY | $541 | — | $541 | 10.95% |
| DIANA LEWIS3 Filed as: DIANA N LEWIS | 28059 US HWY 19 N, STE 201 CLEARWATER, FL 33761 | TRANSAMERICA LIFE INSURANCE COMPANY | $62 | — | $62 | 1.25% |
| GIS BENEFITS INC3 | 422 WAUPONSEE ST MORRIS, IL 60450 | TRANSAMERICA LIFE INSURANCE COMPANY | $10 | — | $10 | 0.20% |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 142 | $1.0M |
| Dental | STARMOUNT LIFE INSURANCE | 83 | $65K |
| Vision | STARMOUNT LIFE INSURANCE | 83 | $65K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 164 | $82K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 164 | $59K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 164 | $59K |
| Other(5 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 164 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.