| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SILVERSTONE GROUP | 11516 MIRACLE HILLS DRIVE, STE 102 OMAHA, NE 68154 | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | $19K | — | $19K | 0.96% |
| TERRY NIELSEN3 | 4809 W 41ST STREET SIOUX FALLS, SD 57106 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 9.89% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCLENNAN AGENCY LLC C/O H&M | 300 CHERAPA PLACE, SUITE 601 SIOUX FALLS, SD 57103 | VISION SERVICE PLAN | $3K | — | $3K | 8.00% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: SUZIE HURLY (SILVERSTONE GROUP) | 1300 W 57TH ST STE 101 SIOUX FALLS, SD 57108 | DELTA DENTAL OF SOUTH DAKOTA | $939 | — | $939 | — |
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 | 263 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 2 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 367 | $0 |
| Vision | VISION SERVICE PLAN | 199 | $34K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 269 | $81K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 269 | $81K |
| Other(2 contracts, 2 carriers) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 269 | $2.1M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 367 | — |
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."
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.