| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NORIDIAN INSURANCE SERVICES INC3 Filed as: NORIDIAN | 4510 13TH AVENUE SW FARGO, ND 58121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $9K | $9K | 5.76% |
| AZURANCE GROUP3 | 4510 13TH AVENUE SW FARGO, ND 58121 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 1.24% |
| HEMB INSURANCE GROUP LLC3 Filed as: HEMB INSURANCE GROUP, LLC | 2801 COHO STREET, SUITE 200 MADISON, WI 53713 | DEAN HEALTH PLAN INC | $3K | $0 | $3K | 2.07% |
| HEMB INSURANCE GROUP LLC3 Filed as: HEMB INSURANCE GROUP, LLC | 2801 COHO STREET, SUITE 200 MADISON, WI 53713 | DELTA DENTAL OF WISCONSIN | $2K | $0 | $2K | 10.00% |
| HEMB INSURANCE GROUP LLC3 Filed as: HEMB INSURANCE GROUP, LLC | 2801 COHO STREET, SUITE 200 MADISON, WI 53713 | WYSSTA INSURANCE COMPANY INC | $197 | $0 | $197 | 7.02% |
| JENNON M CARUTH3 Filed as: JENNON M. CARUTH | 7825 WASHINGTON AVENUE SOUTH SUITE 710 BLOOMINGTON, MN 55439 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $595 | $36 | $631 | 57.26% |
| AZURANCE GROUP3 | 4510 13TH AVENUE SW FARGO, ND 58121 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $397 | $13 | $410 | 37.21% |
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 | 139 | 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) | 139 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 326 | $1.5M |
| Dental(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 326 | $1.4M |
| Vision(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 326 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $151K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $150K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $150K |
| Prescription drug(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 326 | $1.5M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 94 | $150K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 326 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.