| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GREG LITZ | 2005 GATEWAY DRIVE GRAND FORKS, ND 58201 | AFLAC | $9K | — | $9K | 19.01% |
| LAWRENCE R ZAHRADKA | 1726 CEDAR STREET EMERADO, ND 58228 | AFLAC | $7K | $8 | $7K | 13.76% |
| SUSANNA GRACE DEAN | 314 NORTHWESTERN DRIVE GRAND FORKS, ND 58203 | AFLAC | $3K | $21 | $3K | 6.14% |
| SHAWN D BENSER | 4840 AMBER BALLEY PKWY S STE C FARGO, ND 58104 | AFLAC | $2K | — | $2K | 4.65% |
| SASHA CAMPBELL | 5105 49TH AVE S FARGO, ND 58104 | AFLAC | $2K | $6 | $2K | 4.61% |
| KIRK MOTL Filed as: KIRK A MOTL | 3101 LONGBOW CT GRAND FORKS, ND 58203 | AFLAC | $725 | — | $725 | 1.47% |
| ANNETTE ELAINE SPANIER | 534 HARVARD STREET GRAND FORKS, ND 58203 | AFLAC | $113 | — | $113 | 0.23% |
| SHARON NELSON Filed as: SHARON L NELSON | 1030 NORTH 5TH ST WARREN, MN 56762 | AFLAC | $94 | — | $94 | 0.19% |
| JON BENEDA | 303 HOLTEN ST LANKIN, ND 58250 | AFLAC | $62 | — | $62 | 0.13% |
| FARMERS UNION SERV ASSOCIATION LTD | PO BOX 2020 JAMESTOWN, ND 58402 | AFLAC | $22 | — | $22 | 0.04% |
| JUDY INGVALSON Filed as: JUDY J INGVALSON | 15166 13TH ST NE MAYBILLE, ND 58257 | AFLAC | $13 | — | $13 | 0.03% |
| MAXINE BACHMEIER | 3441 6TH AVE NE NORTHWOOD, ND 58267 | AFLAC | $10 | — | $10 | 0.02% |
| CARRIE BJERK | 715 CAMPBELL DRIVE GRAND FORKS, ND 58201 | AFLAC | $9 | — | $9 | 0.02% |
| JEREMY L TOMLINSON | 7825 WASHINGTON AVE S STE 425 MINNEAPOLIS, MN 55439 | AFLAC | $4 | — | $4 | 0.01% |
| MICHAEL D EVANS JR Filed as: MICHAEL EVANS JR | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC | $3 | — | $3 | 0.01% |
| JASON E BLAKE | 3432 CHERRY ST APT B2 GRAND FORKS, ND 58201 | AFLAC | $1 | — | $1 | 0.00% |
| NORIDIAN INSURANCE SERVICES INC3 | 4510 13TH AVE SW FARGO, ND 58121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 19.00% |
| NORIDIAN INSURANCE SERVICES INC3 | 4510 13TH AVE SW FARGO, ND 581210001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 19.00% |
| NORIDIAN INSURANCE SERVICES INC3 | 4510 13TH AVE SW FARGO, ND 58121 | USABLE LIFE | $967 | — | $967 | 20.43% |
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 | 194 | 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) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 179 | $354K |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 226 | $0 |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 191 | $26K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 142 | $54K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 179 | $354K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 179 | $354K |
| Other(2 contracts, 2 carriers) | AFLAC | 191 | $66K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 226 | — |
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.
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.