| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | UNKNOWN FARGO, ND 58108 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $22K | $0 | $22K | 1.48% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | DELTA DENTAL OF MINNESOTA | $9K | $0 | $9K | 9.13% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS | 11516 MIRACLE HILLS DRIVE SUITE 102 OMAHA, NE 68154 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $9K | $2K | $11K | 17.03% |
| AZURANCE GROUP3 Filed as: AZURANCE GROUP INC | 4510 13TH AVENUE SW FARGO, ND 58151 | USABLE LIFE | $74 | $0 | $74 | 3.99% |
| JUDY HANSEN3 | 8314 80TH AVENUE, SOUTH SABIN, MN 56580 | USABLE LIFE | $17 | $0 | $17 | 0.92% |
| CHRISTINE MARTEL3 | 6721 100TH STREET GLYNDON, MN 56547 | USABLE LIFE | $2 | $0 | $2 | 0.11% |
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 | 136 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 228 | $1.5M |
| Dental | DELTA DENTAL OF MINNESOTA | 211 | $101K |
| Vision | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 228 | $1.5M |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $65K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $65K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 228 | $1.5M |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 136 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.