| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | UNKNOWN FARGO, ND 58104 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $16K | $0 | $16K | 1.25% |
| BELL INSURANCE SERVICES3 | UNKNOWN FARGO, ND 58104 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $3K | $0 | $3K | 0.23% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $11K | $3K | $14K | 9.47% |
| GIS BENEFITS INC3 | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $2K | $5K | 3.46% |
| BELL INSURANCE SERVICES3 | PO BOX 1470 FARGO, ND 58107 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 1.44% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $879 | $879 | 0.60% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DRIVE SUITE 100 OMAHA, NE 68154 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $47 | $47 | 0.03% |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 152 | $1.3M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $147K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $147K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $147K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $147K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $147K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 152 | $1.3M |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 164 | $147K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 164 | — |
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.
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.