| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP LLC | 1300 W 57TH ST STE 101 SIOUX FALLS, SD 57108 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $20K | — | $20K | 5.92% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP | SUITE 100 11516 MIARCLE HILLS DR OMAHA, NE 68154 | DELTA DENTAL OF MINNESOTA | $15K | — | $15K | 5.92% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP | 11516 MIRACLE HOUSE DRIVE, STE 1002 OMAHA, NE 68154 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| HALVORSON BENEFITS PLUS INC3 Filed as: HALVORSON BENEFITS PLUS | PO BOX 2125 FARGO, ND 58107 | STANDARD INSURANCE COMPANY | $4K | — | $4K | 11.04% |
| HALVORSON BENEFITS PLUS INC3 | 3320 WESTRAC DR SUITE D FARGO, ND 58103 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 9.99% |
| HALVORSON BENEFITS PLUS INC3 Filed as: HALVORSON BENEFITS PLUS | PO BOX 2125 FARGO, ND 58107 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 10.30% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELTA DENTAL EIN 41-0952670 | Contract Administrator Service code 13 | — | $25K |
| PRIME THERAPEUTICS NONE | Other fees Service code 99 | 1305 CORPORATE CENTER DRIVE EAGAN, MN 55121 | $0 |
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 | 428 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 431 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 508 | $344K |
| Dental | DELTA DENTAL OF MINNESOTA | 562 | $247K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 433 | $37K |
| Life insurance(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 420 | $43K |
| Long-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 401 | $64K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 508 | $344K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 420 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 562 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.