| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MICHELE ADELE FREEBURY3 | 427 11TH ST NW MINOT, ND 58703 | AFLAC | $8K | $691 | $8K | 14.00% |
| LEANNE R PETERSON3 | 603 STEVENSON ST NW BERTHOLD, ND 58718 | AFLAC | $2K | — | $2K | 3.74% |
| PAYTON LEE DEMARS3 | PO BOX 23 SURREY, ND 58785 | AFLAC | $2K | $22 | $2K | 3.06% |
| JARCEY RAUL RODRIGUEZ3 | 202 S 1ST AVE STE 108 YUMA, AZ 85364 | AFLAC | $1K | — | $1K | 1.90% |
| PATRICK K RICKERL3 | 3300 S PILLSBERRY AVE SIOUX FALLS, SD 57103 | AFLAC | $926 | $170 | $1K | 1.87% |
| EVENSON INSURANCE AGENCY INC3 | 1316 20TH AVE SW MINOT, ND 58701 | AFLAC | $1K | — | $1K | 1.79% |
| BRIAN D DORFF3 | 9194 32ND AVE S GRAND FORKS, ND 58201 | AFLAC | $407 | — | $407 | 0.69% |
| DIANA L GITZ3 | 889 SHELBIE AVE BRAWLEY, CA 92227 | AFLAC | $391 | — | $391 | 0.67% |
| MORETON & COMPANY3 Filed as: JASON THOMAS MORTON | 3960 SWEETSPIRE DR LEXINGTON, KY 40514 | AFLAC | $338 | — | $338 | 0.58% |
| ZACK PLOTZKER3 | 1312 OZONE AVE SANTA MONICA, CA 90405 | AFLAC | $278 | — | $278 | 0.47% |
| FRANCINE MARIE DIXON3 | 2900 43RD AVE SE MINOT, ND 58701 | AFLAC | $253 | — | $253 | 0.43% |
| CHELSEY N NICHOLS3 | PO BOX 1235 MINOT, ND 58702 | AFLAC | $237 | — | $237 | 0.40% |
| FILIPE A COELHO3 | 4515 S MCCLINTOCK DR STE 212 TEMPE, AZ 85282 | AFLAC | $187 | — | $187 | 0.32% |
| ZACK PLOTZKER3 | 8759 CASHIO ST LOS ANGELES, CA 90035 | AFLAC | $159 | — | $159 | 0.27% |
| MICHAEL BENSON3 | 922 14TH ST APT 204 SANTA MONICA, CA 90403 | AFLAC | $151 | — | $151 | 0.26% |
| GEORGE E ARBID3 | 25728 LEWIS WAY STEVENSON RANCH, CA 91381 | AFLAC | $149 | — | $149 | 0.25% |
| BRANDI LARSON3 | 19 MEADOW LN STANLEY, ND 58784 | AFLAC | $141 | — | $141 | 0.24% |
| MARY ANN KELLER3 | 1821 TAMMY DR MINOT, ND 58701 | AFLAC | $103 | — | $103 | 0.18% |
| GREG LITZ | 10 S 3RD ST GRAND FORKS, ND 58201 | AFLAC | $84 | — | $84 | 0.14% |
| LAWRENCE R ZAHRADKA3 | 10 S 3RD ST GRAND FORKS, ND 58201 | AFLAC | $73 | — | $73 | 0.12% |
| WHITNEY L MILLWOOD3 | 3944 MURPHY CANYON RD STE C203 SAN DIEGO, CA 92123 | AFLAC | $64 | — | $64 | 0.11% |
| KIMBERLY J WELSTAD3 | 1513 COOK DR MINOT, ND 58701 | AFLAC | $22 | — | $22 | 0.04% |
| GENEIL M VEDAA3 | PO BOX 550 VELVA, ND 58790 | AFLAC | $16 | — | $16 | 0.03% |
| CYNTHIA D WELKEN-PLACE3 | 601 CODY DR BISMARCK, ND 58503 | AFLAC | $8 | — | $8 | 0.01% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC | $2 | — | $2 | 0.00% |
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 | 82 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Other | AFLAC | 138 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 138 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.