| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $125K | $0 | $125K | 5.02% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $358 | $358 | 0.01% |
| ROBERT C BROWER Filed as: ROBERT C. BROWER | 2 EAST GILMAN STREET MADISON, WI 57303 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | $0 | $3K | 3.00% |
| KAREN BALZER-ROBBINS3 | 10501 BRADDOCK ROAD, SUITE 204 FAIRFAX, VA 22032 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $124 | $0 | $124 | 0.11% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $6K | $0 | $6K | 7.50% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $561 | $6K | 14.44% |
| AZURANCE GROUP3 | 4510 13TH AVENUE SOUTH FARGO, ND 58121 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $0 | $2K | 4.43% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | HARTFORD FIRE INSURANCE COMPANY | $0 | $2K | $2K | 17.00% |
| ALLIANCE INSURANCE GROUP LLC3 Filed as: ALLIANCE INSURANCE SERVICES | 5444 WESTHEIMER ROAD, SUITE 800 HOUSTON, TX 77056 | HARTFORD FIRE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
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 | 1,762 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 242 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,004 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 5,769 | $3.2M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 5,769 | $3.4M |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,860 | $2.6M |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,860 | $2.5M |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 5,769 | $3.2M |
| Other(5 contracts, 5 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,860 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,769 | — |
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.