| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| KEITH OLSON3 Filed as: KEITH A OLSON | 427 31ST AVE E WEST FARGO, ND 58078 | AFLAC | $9K | $657 | $10K | 9.48% |
| THOMAS J CASSADY3 | 1307 NP AVE N FARGO, ND 58102 | AFLAC | $1K | $134 | $2K | 1.57% |
| SASHA CAMPBELL3 Filed as: SASHA L CAMPBELL | 2731 12TH AVE S STE B FARGO, ND 58103 | AFLAC | $1K | $132 | $1K | 1.33% |
| ANDREW C MJONESS3 | 2917 14TH AVE S MOORHEAD, MN 56560 | AFLAC | $1K | $0 | $1K | 1.18% |
| SHAWN D BENSER3 | 422 SEQUOIA DR MAPLETON, ND 58059 | AFLAC | $639 | $0 | $639 | 0.62% |
| JAMIE SOLVEIG VERLINDEN3 | 537 5TH ST E APT 6 WEST FARGO, ND 58078 | AFLAC | $544 | $0 | $544 | 0.53% |
| MANDY P RUECHEL3 | 1030 LUM AVE WATERLOO, WI 53594 | AFLAC | $360 | $42 | $402 | 0.39% |
| COLE CASEY CROMPTON | 116 15TH ST S MOORHEAD, MN 56560 | AFLAC | $384 | $0 | $384 | 0.37% |
| MOLLY E LEE3 | 4840 E DIAMOND DR PRESCOTT, AZ 86301 | AFLAC | $331 | $24 | $355 | 0.34% |
| KATRINA REINKE3 | 1503 6TH AVE N WAHPETON, ND 58075 | AFLAC | $275 | $52 | $327 | 0.32% |
| ANDREW C MJONESS3 Filed as: ANDREW MJONESS | 2917 14TH AVE S MOORHEAD, MN 56560 | AFLAC | $255 | $0 | $255 | 0.25% |
| GREGORY A NESS3 | 3701 WESTMOOR DR MOORHEAD, MN 56560 | AFLAC | $187 | $44 | $231 | 0.22% |
| KIMBERLA KAY LUCIER3 | 1409 7TH ST N FARGO, ND 58102 | AFLAC | $204 | $0 | $204 | 0.20% |
| MICHAEL FRASIER3 | 258 CORPORATE DR STE 200 MADISON, WI 53714 | AFLAC | $109 | $14 | $123 | 0.12% |
| CORY A SMITH3 | PO BOX 75 MOORHEAD, MN 56561 | AFLAC | $101 | $0 | $101 | 0.10% |
| JESSICA RAE LECKNER3 | 6051 14TH ST S FARGO, ND 58104 | AFLAC | $79 | $0 | $79 | 0.08% |
| JASON OCHSENDORF3 | 3761 16TH ST S MOORHEAD, MN 56560 | AFLAC | $67 | $0 | $67 | 0.06% |
| REBECCA A BAERTSCHI3 | 209 W MAIN ST BROOKLYN, WI 53521 | AFLAC | $56 | $0 | $56 | 0.05% |
| MARC A HANSON3 | 1207 PRAIRIE PARKWAY WEST FARGO, ND 58078 | AFLAC | $52 | $0 | $52 | 0.05% |
| CASEY J HIGGINS3 | 9347 LIZARD ROCK TRL COLORADO SPRINGS, CO 80924 | AFLAC | $43 | $0 | $43 | 0.04% |
| JASON EARL BLAKE3 | 1226 CULVER AVE NW BUFFALO, MN 55313 | AFLAC | $43 | $0 | $43 | 0.04% |
| HEIDI JOAN MORGAN3 | 1006 W 10TH ST SIOUX FALLS, SD 57104 | AFLAC | $40 | $0 | $40 | 0.04% |
| TERRY E ANDERSON3 | 700 CEDAR ST STE 185 ALEXANDRIA, MN 56308 | AFLAC | $26 | $0 | $26 | 0.03% |
| DALANA KAY MAYER3 | 5755 PRAIRIEWOOD DR BISMARCK, ND 58504 | AFLAC | $21 | $0 | $21 | 0.02% |
| ROBIN K SWANSON3 | 4820 30TH AVE S STE 100 FARGO, ND 58104 | AFLAC | $20 | $0 | $20 | 0.02% |
| AMBER MUSKE3 | 11769 31ST ST SE VALLEY CITY, ND 58072 | AFLAC | $18 | $0 | $18 | 0.02% |
| SANDRA F STRANDLIEN3 | 1307 NP AVE N FARGO, ND 58102 | AFLAC | $14 | $0 | $14 | 0.01% |
| MELISSA ANN VAN EREM3 | 2301 25TH AVE S FARGO, ND 58103 | AFLAC | $10 | $0 | $10 | 0.01% |
| KRISTINE M VOEGELI3 | 4301 KENWOOD ST MADISON, WI 53704 | AFLAC | $10 | $0 | $10 | 0.01% |
| LONNA DEHN INSURANCE AGCY INC3 | 1202 23RD ST S, STE 1 FARGO, ND 58103 | AFLAC | $9 | $0 | $9 | 0.01% |
| MICHELLE M HOUGH3 | 201 E VERLEEN AVE WAUNAKEE, WI 53597 | AFLAC | $9 | $0 | $9 | 0.01% |
| MATTHEW RUECHEL3 | 1030 LUM AVE WATERLOO, WI 53594 | AFLAC | $8 | $0 | $8 | 0.01% |
| JOHN PAUL THOMPSON SR3 | 6395 S KEWAUNEE WAY, STE 425 AURORA, CO 80016 | AFLAC | $5 | $0 | $5 | 0.00% |
| GLEN T SCHWEIKERT3 | 2211 HIGHLAND SPRINGS PL LOUISVILLE, KY 40245 | AFLAC | $4 | $0 | $4 | 0.00% |
| JEFFREY M HANSEN3 | 1895 52ND ST SW PEQUOT LAKES, MN 56472 | AFLAC | $3 | $0 | $3 | 0.00% |
| DONALD LARRY REYNOLDS3 | 8945 33RD ST N # B LAKE ELMO, MN 55042 | AFLAC | $2 | $0 | $2 | 0.00% |
| CAROL J HANSEN3 | 35235 BIRCHDALE VILLA DR PEQUOT LAKES, MN 56472 | AFLAC | $2 | $0 | $2 | 0.00% |
| WILLIAM F MURRAY III3 | 1298 SAINT PATRICK WAY SUN PRAIRIE, WI 53590 | AFLAC | $1 | $0 | $1 | 0.00% |
| GREGORY F STENZEL3 | 14054 BADIANDS DR FRISCO, TX 75035 | AFLAC | $1 | $0 | $1 | 0.00% |
| MICHELLE RAE MAGUIRE3 | 7825 WASHINGTON AVE S SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $1 | $0 | $1 | 0.00% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $705 | $5K | 17.42% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $599 | $3K | 12.50% |
| ANSAY & ASSOCIATES LLC3 | 101 E GRAND AVE STE 200 PORT WASHINGTON, WI 53074 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $462 | $3K | 16.59% |
| ANSAY & ASSOCIATES LLC3 | 2901 W BELTLINE HWY STE 202 MADISON, WI 53713 | STARMOUNT LIFE INSURANCE COMPANY | $1K | $0 | $1K | 11.99% |
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 | 81 | 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) | 81 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 75 | $10K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 75 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 105 | $29K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 119 | $127K |
| Long-term disability(2 contracts, 2 carriers) | AFLAC | 119 | $122K |
| Other(2 contracts, 2 carriers) | AFLAC | 119 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 119 | — |
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.