| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES3 | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | SANFORD HEALTH PLAN | $75K | — | $75K | 2.00% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INSURANCE SERVICE | 700 W 47TH ST STE 1100 KANSAS CITY, MO 64112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| GAIL PLUMMER3 | 4372 43RD AVE SOUTH FARGO, ND 58104 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $3K | — | $3K | 6.28% |
| TERI L SWARTZENDRUBER3 | 1805 5TH AVE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $113 | — | $113 | 0.27% |
| JON SCOTT SWARTZENDRUBER3 | 1805 5TH AVE ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $112 | — | $112 | 0.27% |
| ZACHARY M SWARTZENDRUBER3 Filed as: ZACHARY M. SWARTZENDRUBER | 14128 BARIUM ST NW ANOKA, MN 55303 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $93 | $18 | $111 | 0.27% |
| REBECCA COSTE3 | 619 5TH ST E WEST FARGO, ND 58078 | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | $97 | — | $97 | 0.24% |
| CASCADE PROFESSIONAL CENTER3 | 100 FINANCIAL DRIVE #110 KALISPELL, MT 59901 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 6.38% |
| CASCADE PROFESSIONAL CENTER3 | 100 FINANCIAL DRIVE #110 KALISPELL, MT 59901 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.13% |
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 | 274 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SANFORD HEALTH PLAN | 437 | $3.8M |
| Dental | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA (DENTAL) | 573 | $180K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 263 | $61K |
| Life insurance(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | 379 | $86K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENTAL INSURANCE COMPANY | 379 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 573 | — |
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.