| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 Filed as: NATHAN B. CORBIN AND VARIOUS AGENTS | 404 2ND AVENUE NW MANDAN, ND 58554 | AFLAC | $4K | $314 | $4K | 6.47% |
| KIRK MOTL3 Filed as: KIRK A. MOTL | 3101 LONGBOW COURT GRAND FORKS, ND 58203 | AFLAC | $3K | $252 | $3K | 5.51% |
| GENEIL M VEDAA3 Filed as: GENEIL M. VEDAA | PO BOX 550 VELVA, ND 58790 | AFLAC | $2K | $100 | $2K | 3.07% |
| ELLIE PAPINEAU LLC3 Filed as: ELLIE PAPINEAU, LLC | 739 ALDRICH STREET DICKINSON, ND 58601 | AFLAC | $1K | $34 | $1K | 2.07% |
| GREG LITZ3 | 2005 GATEWAY DRIVE GRAND FORKS, ND 58203 | AFLAC | $736 | $54 | $790 | 1.26% |
| MELISSA STUART INC3 Filed as: MELISSA STUART, INC. | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC | $585 | $44 | $629 | 1.01% |
| SUSANNA GRACE DEAN3 | 314 NORTHWESTERN DRIVE NORTH FORKS, ND 58203 | AFLAC | $559 | $11 | $570 | 0.91% |
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 | 142 | 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) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 95 | $63K |
| Dental | AFLAC | 95 | $63K |
| Short-term disability | AFLAC | 95 | $63K |
| Long-term disability | AFLAC | 95 | $63K |
| Other | AFLAC | 95 | $63K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 95 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.