| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AMERICAN INSURANCE INC3 | 38 1ST ST W DICKINSON, ND 58601 | METROPOLITAN LIFE INSURANCE COMPANY | $24K | — | $24K | 7.68% |
| MELISSA STUART INC3 | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $3K | $318 | $3K | 5.79% |
| AMERICAN INSURANCE INC4 | 38 1ST ST W DICKINSON, ND 58601 | AFLAC (GROUP UZ329) | $3K | — | $3K | 4.79% |
| KATE PALCZEWSKI INC3 | 3412 CHISHOLM TRL BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $2K | $64 | $2K | 3.28% |
| CSP INSURANCE AGENT INC3 | 1110 COLLEGE DRIVE STE 215 BISMARCK, ND 58501 | AFLAC (GROUP UZ329) | $1K | $64 | $1K | 2.57% |
| MELISSA STUART INC3 Filed as: MELISSA STUART | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $389 | $217 | $606 | 1.06% |
| MICHAEL D EVANS JR4 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC (GROUP UZ329) | $450 | $109 | $559 | 0.98% |
| CYNTHIA D WELKEN-PLACE4 | 601 CODY DR BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $389 | — | $389 | 0.68% |
| BRANDI LARSON4 Filed as: BRANDI BIERI | PO BOX 578 STANLEY, ND 58784 | AFLAC (GROUP UZ329) | $319 | $41 | $360 | 0.63% |
| KATE PALCZEWSKI INC4 Filed as: KATE PALCZEWSKI | 3412 CHISHOLM TRL BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $235 | $42 | $277 | 0.49% |
| CHELSEY N NICHOLS4 Filed as: CHELSEY N WOLLA | PO BOX 1235 MINOT, ND 58702 | AFLAC (GROUP UZ329) | $161 | $10 | $171 | 0.30% |
| CARRIE PALCZEWSKI4 | 4207 BOULDER RIDGE ROAD STE 140 BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $126 | $39 | $165 | 0.29% |
| LEANNE R PETERSON4 | 603 STEVENSON ST NW BERTHOLD, ND 58718 | AFLAC (GROUP UZ329) | $99 | $10 | $109 | 0.19% |
| CHRISTI M JESKE4 | 101 104TH AVE SW KILLDEER, ND 58640 | AFLAC (GROUP UZ329) | $75 | — | $75 | 0.13% |
| JULIE BEHRENS AGENCY LLC3 | 1800 E MAIN ST STE C MANDAN, ND 58554 | AFLAC (GROUP UZ329) | $66 | — | $66 | 0.12% |
| GENEIL M VEDAA4 | BOX 550 VELVA, ND 58790 | AFLAC (GROUP UZ329) | $66 | — | $66 | 0.12% |
| KATHLEEN K JOHNSON4 | 610 27TH ST W DICKINSON, ND 58601 | AFLAC (GROUP UZ329) | $50 | — | $50 | 0.09% |
| LAWRENCE A NEHRING4 | PO BOX 518 MOHALL, ND 58761 | AFLAC (GROUP UZ329) | $48 | — | $48 | 0.08% |
| YVONNE M CAMPBELL4 | 500 2ND AVE EAST LEMMON, SD 57638 | AFLAC (GROUP UZ329) | $38 | — | $38 | 0.07% |
| JESSICA FRINK4 | 3229 LINK DR BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $32 | — | $32 | 0.06% |
| CHARLOTTE HEIM4 | 11212 71ST AVE NE BISMARCK, ND 58503 | AFLAC (GROUP UZ329) | $31 | — | $31 | 0.05% |
| GUENOT ENTERPRISES INC3 | 1501 CENTRE ST STE 201 RAPID CITY, SD 57703 | AFLAC (GROUP UZ329) | $26 | — | $26 | 0.05% |
| LYNN A BROKAW4 | 1406 S RENO DR BISMARCK, ND 58504 | AFLAC (GROUP UZ329) | $23 | — | $23 | 0.04% |
| STEPHEN C JONES4 | PO BOX 17284 MISSOULA, MT 59808 | AFLAC (GROUP UZ329) | $23 | — | $23 | 0.04% |
| EUGENE BUTCH LINSTER4 | 3611 ANGEL WAY COURT RAPID CITY, SD 57703 | AFLAC (GROUP UZ329) | $21 | — | $21 | 0.04% |
| MICHAEL D EVANS JR4 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC (GROUP UZ329) | $15 | — | $15 | 0.03% |
| SCOTT C OLSEN4 | 3534 SAWGRASS CT RAPID CITY, SD 57703 | AFLAC (GROUP UZ329) | $14 | — | $14 | 0.02% |
| NATHAN BUTLER CORBIN4 | 404 2ND AVE NW MANDAN, ND 58554 | AFLAC (GROUP UZ329) | $13 | — | $13 | 0.02% |
| DACOTAH BANK4 | PO BOX 1210 ABERDEEN, SD 57401 | AFLAC (GROUP UZ329) | $11 | — | $11 | 0.02% |
| KEVIN B VINING4 | 24747 HIDDEN VALLEY ROAD HERMOSA, SD 57744 | AFLAC (GROUP UZ329) | $10 | — | $10 | 0.02% |
| DAVID A MIDDAUGH4 | PO BOX 2543 FARGO, ND 58108 | AFLAC (GROUP UZ329) | $3 | — | $3 | 0.01% |
| CRAIG WAYNE SOTTILE4 Filed as: CRAIG CIMBURA | 115 SCHOENES DR SW PIERZ, MN 56364 | AFLAC (GROUP UZ329) | $2 | — | $2 | 0.00% |
| ANDREW C MJONESS4 | 4840 AMBER VALLEY PKWY S STE C FARGO, ND 58104 | AFLAC (GROUP UZ329) | $1 | — | $1 | 0.00% |
| J THEIS & ASSOCIATES INC3 | 960 S 24TH ST W SUITE H BILLINGS, MT 59102 | AFLAC (GROUP UZ329) | $1 | — | $1 | 0.00% |
| AMERICAN INSURANCE INC3 | 38 1ST ST W DICKINSON, ND 58601 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| DIRECT BENEFITS INC4 Filed as: DIRECT BENEFITS | 325 CEDAR STREET ST. PAUL, MN 55101 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.00% |
| MELISSA STUART INC4 | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC (GROUP UZ323) | $844 | $44 | $888 | 6.37% |
| AMERICAN INSURANCE INC3 | 38 1ST ST W DICKINSON, ND 58601 | AFLAC (GROUP UZ323) | $883 | — | $883 | 6.34% |
| KATE PALCZEWSKI INC4 | 3412 CHISHOLM TRL BISMARCK, ND 58503 | AFLAC (GROUP UZ323) | $649 | $9 | $658 | 4.72% |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD STE 140 BISMARCK, ND 58503 | AFLAC (GROUP UZ323) | $394 | $9 | $403 | 2.89% |
| BRANDI LARSON4 Filed as: BRANDI BIERI | PO BOX 578 STANLEY, ND 58784 | AFLAC (GROUP UZ323) | $236 | — | $236 | 1.69% |
| CHELSEY N NICHOLS Filed as: CHELSEY N WOLLA | PO BOX 1235 MINOT, ND 58702 | AFLAC (GROUP UZ323) | $121 | — | $121 | 0.87% |
| MICHAEL D EVANS JR4 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC (GROUP UZ323) | $105 | $9 | $114 | 0.82% |
| JESSICA FRINK | 3229 LINK DR BISMARCK, ND 58503 | AFLAC (GROUP UZ323) | $104 | — | $104 | 0.75% |
| CYNTHIA D WELKEN-PLACE4 | 601 CODY DR BISMARCK, ND 58503 | AFLAC (GROUP UZ323) | $98 | — | $98 | 0.70% |
| LEANNE R PETERSON | 603 STEVENSON ST NW BERTHOLD, ND 58718 | AFLAC (GROUP UZ323) | $77 | — | $77 | 0.55% |
| GARY C KLEIN4 | 5924 BALFOUR CT STE 100 CARLSBAD, CA 92008 | AFLAC (GROUP UZ323) | $33 | — | $33 | 0.24% |
| KATHLEEN K JOHNSON4 | 610 27TH ST W DICKINSON, ND 58601 | AFLAC (GROUP UZ323) | $32 | — | $32 | 0.23% |
| NATHAN BUTLER CORBIN4 | 404 2ND AVE NW MANDAN, ND 58554 | AFLAC (GROUP UZ323) | $17 | — | $17 | 0.12% |
| JOHN J FREDERICK4 | PO BOX 554, 8108 HIGHWAY 14 DAYTON, WY 82836 | AFLAC (GROUP UZ323) | $10 | — | $10 | 0.07% |
| BRENDA K VANBERKOM4 | PO BOX 168 POWERS LAKE, ND 58773 | AFLAC (GROUP UZ323) | $9 | — | $9 | 0.06% |
| DAKOTA COMMUNITY BANK | PO BOX 431 HEBRON, ND 58638 | AFLAC (GROUP UZ323) | $9 | — | $9 | 0.06% |
| FIRST DAKOTA INC4 | 5555 W GRANDE MARKET DR APPLETON, ND 54913 | AFLAC (GROUP UZ323) | $4 | — | $4 | 0.03% |
| MICHAEL D EVANS JR Filed as: MICHAEL J TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC (GROUP UZ323) | $4 | — | $4 | 0.03% |
| SCOTT WEBB | 2355 W PINNACLE PEAK RD ST 380 PHOENIX, AZ 85027 | AFLAC (GROUP UZ323) | $2 | — | $2 | 0.01% |
| MELISSA STUART INC3 | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC (GROUP UZ298) | $220 | $29 | $249 | 2.86% |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD STE 140 BISMARCK, ND 58503 | AFLAC (GROUP UZ298) | $146 | $6 | $152 | 1.74% |
| AMERICAN INSURANCE INC4 | 38 1ST ST W DICKINSON, ND 58601 | AFLAC (GROUP UZ298) | $146 | — | $146 | 1.68% |
| CYNTHIA D WELKEN-PLACE4 | 601 CODY DR BISMARCK, ND 58503 | AFLAC (GROUP UZ298) | $95 | — | $95 | 1.09% |
| KATE PALCZEWSKI INC4 | 3412 CHISHOLM TRL BISMARCK, ND 58503 | AFLAC (GROUP UZ298) | $75 | $6 | $81 | 0.93% |
| MICHAEL D EVANS JR4 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC (GROUP UZ298) | $58 | $6 | $64 | 0.73% |
| CHRISTI M JESKE4 | 101 104TH AVE SW KILLDEER, ND 58640 | AFLAC (GROUP UZ298) | $53 | — | $53 | 0.61% |
| ELOISE KLOSE4 | 338 NORTH 31 STREET #6 BISMARCK, ND 58501 | AFLAC (GROUP UZ298) | $53 | — | $53 | 0.61% |
| JOHN J FREDERICK4 | PO BOX 554, 8108 HIGHWAY 14 DAYTON, WY 82836 | AFLAC (GROUP UZ298) | $52 | — | $52 | 0.60% |
| GENEIL M VEDAA4 | BOX 550 VELVA, ND 58790 | AFLAC (GROUP UZ298) | $28 | — | $28 | 0.32% |
| BRENDA K VANBERKOM4 | PO BOX 168 POWERS LAKE, ND 58773 | AFLAC (GROUP UZ298) | $22 | — | $22 | 0.25% |
| GARY C KLEIN4 | 5924 BALFOUR CT STE 100 CARLSBAD, CA 92008 | AFLAC (GROUP UZ298) | $20 | — | $20 | 0.23% |
| BRANDI LARSON4 Filed as: BRANDI BIERI | PO BOX 578 STANLEY, ND 58784 | AFLAC (GROUP UZ298) | $17 | — | $17 | 0.20% |
| MICHAEL D EVANS JR4 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC (GROUP UZ298) | $9 | — | $9 | 0.10% |
| LEANNE R PETERSON4 | 603 STEVENSON ST NW BERTHOLD, ND 58718 | AFLAC (GROUP UZ298) | $4 | — | $4 | 0.05% |
| FIRST DAKOTA INC4 | 5555 W GRANDE MARKET DR APPLETON, WI 54913 | AFLAC (GROUP UZ298) | $4 | — | $4 | 0.05% |
| MELISSA STUART INC4 | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC (GROUP E6W83) | $620 | $105 | $725 | 12.06% |
| AMERICAN INSURANCE INC3 | 38 1ST ST W DICKINSON, ND 58601 | AFLAC (GROUP E6W83) | $454 | — | $454 | 7.55% |
| KATE PALCZEWSKI INC4 | 3412 CHISHOLM TRL BISMARCK, ND 58503 | AFLAC (GROUP E6W83) | $308 | $35 | $343 | 5.70% |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD STE 140 BISMARCK, ND 58503 | AFLAC (GROUP E6W83) | $199 | $23 | $222 | 3.69% |
| MICHAEL D EVANS JR4 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC (GROUP E6W83) | $38 | $5 | $43 | 0.72% |
| CYNTHIA D WELKEN-PLACE4 | 601 CODY DR BISMARCK, ND 58503 | AFLAC (GROUP E6W83) | $23 | — | $23 | 0.38% |
| MELISSA STUART INC4 | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC (GROUP F7G61) | $35 | — | $35 | 4.04% |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD STE 140 BISMARCK, ND 58503 | AFLAC (GROUP F7G61) | $31 | — | $31 | 3.58% |
| AMERICAN INSURANCE INC3 | 38 1ST ST W DICKINSON, ND 58601 | AFLAC (GROUP F7G61) | $23 | — | $23 | 2.66% |
| CYNTHIA D WELKEN-PLACE4 | 601 CODY DR BISMARCK, ND 58503 | AFLAC (GROUP F7G61) | $15 | — | $15 | 1.73% |
| MICHAEL D EVANS JR4 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC (GROUP F7G61) | $9 | — | $9 | 1.04% |
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 | 697 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 697 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 458 | $2.0M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 697 | $318K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 304 | $36K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 697 | $318K |
| Short-term disability(5 contracts, 5 carriers) | AFLAC (GROUP UZ329) | 84 | $86K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 697 | $318K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 697 | $318K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 697 | — |
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."
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.