| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BYWATER INSURANCE5 | 15422 DETROIT AVE LAKEWOOD, OH 44107 | NATIONWIDE LIFE INSURANCE COMPANY | $50K | — | $50K | 11.55% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: PERRY BORELLA, HUB INT'L | 2630 JACKSON BLVD STE 202 RAPID CITY, SD 57709 | DELTA DENTAL OF SOUTH DAKOTA | $1K | — | $1K | 1.58% |
| DAN MAGUIRE BLACK HILLS INS AGENCY3 | 820 ST JOSEPH ST PO BOX 3330 RAPID CITY, SD 57709 | DELTA DENTAL OF SOUTH DAKOTA | $379 | — | $379 | 0.53% |
| WENDY L SWARTZ3 | 3409 W MAIN ST RAPID CITY, SD 57702 | AFLAC | $4K | $189 | $4K | 7.55% |
| SCOTT C OLSEN3 | 4132 CARMEL PT RAPID CITY, SD 57702 | AFLAC | $794 | — | $794 | 1.45% |
| AMBER M LIND3 | 3409 W MAIN STREET RAPID CITY, SD 57702 | AFLAC | $747 | $45 | $792 | 1.44% |
| BROOKE A GEDDES3 | 705 PRO RODEO DR SPEARFISH, SD 57783 | AFLAC | $603 | $89 | $692 | 1.26% |
| EUGENE BUTCH LINSTER3 Filed as: EUGENE LINSTER | 3611 ANGEL WAY RAPID CITY, SD 57703 | AFLAC | $334 | — | $334 | 0.61% |
| JACLYN ROSE MANN3 | PO BOX 566 RAPID CITY, SD 57709 | AFLAC | $296 | — | $296 | 0.54% |
| KRISTI ENDRES3 | 1305 22ND ST NE WATERTOWN, SD 57201 | AFLAC | $240 | $13 | $253 | 0.46% |
| DEBORAH J LANGENFELD HOOPS3 Filed as: DEBORAH LANGENFELD HOOPS | PO BOX 462 HURON, SD 57350 | AFLAC | $214 | — | $214 | 0.39% |
| KEVIN B VINING3 | 47269 255TH ST RENNER, SD 57055 | AFLAC | $155 | — | $155 | 0.28% |
| EDWARD O HALVORSON JR3 | 8488 HUFFINE LANE BOZEMAN, MT 59718 | AFLAC | $129 | — | $129 | 0.24% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC | $120 | — | $120 | 0.22% |
| CAROL A BENDER3 | 2969 ATLANTIC BLVD INGLESIDE, TX 78362 | AFLAC | $108 | — | $108 | 0.20% |
| ROBIN NEFZGER3 | 524 WEST LAKE DRIVE LAKE NORDEN, SD 57248 | AFLAC | $80 | $3 | $83 | 0.15% |
| PATRICK O'LEARY3 | 203 W BRIDGE STREET REDWOOD FALLS, MN 56283 | AFLAC | $80 | — | $80 | 0.15% |
| KAYLA ANN SCHAD3 | 3513 HALL STREET RAPID CITY, SD 57702 | AFLAC | $76 | — | $76 | 0.14% |
| MELISSA STUART INC3 | 921 BREMNER AVE BISMARCK, ND 58503 | AFLAC | $49 | $23 | $72 | 0.13% |
| SHAWN D BENSER3 | 4840 AMBER VALLEY PKWY S., STE C FARGO, ND 58104 | AFLAC | $63 | — | $63 | 0.11% |
| DALE N BERG3 | 596 MAIN ST DEADWOOD, SD 57732 | AFLAC | $61 | — | $61 | 0.11% |
| GLORIA J MAHER3 | 213 N LAKE AVE SIOUX FALLS, SD 57104 | AFLAC | $57 | — | $57 | 0.10% |
| LANCE D THORSON3 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC | $55 | — | $55 | 0.10% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL EVANS JR | 113 5TH STREET SE WATERTOWN, SD 57201 | AFLAC | $50 | — | $50 | 0.09% |
| MICHAEL BOLGER3 | 128 WOODLAND DR. MADISON, SD 57042 | AFLAC | $42 | — | $42 | 0.08% |
| TERRY L JENSEN3 | 32822 TURTLE SHORE LN UNDERWOOD, MN 56586 | AFLAC | $35 | — | $35 | 0.06% |
| SHON FORD LLC3 Filed as: SHON FORD | 427 N BROADWAY AVE MILLER, SD 57362 | AFLAC | $31 | $3 | $34 | 0.06% |
| KYLE D SULLIVAN3 Filed as: KYLE SULLIVAN | PO BOX 2290 MILLS, WY 82644 | AFLAC | $33 | — | $33 | 0.06% |
| PEAK INC3 | 40658 252ND ST MITCHELL, SD 57301 | AFLAC | $32 | — | $32 | 0.06% |
| STENGRIM INS INC3 | 47108 276TH ST HARRISBURG, SD 57032 | AFLAC | $32 | — | $32 | 0.06% |
| BLW INC3 | 4840 AMBER VALLEY PKW S, STE. C FARGO, ND 58104 | AFLAC | $32 | — | $32 | 0.06% |
| LISA K UHLIR3 | 8516 E WILLOW RIDGE PLACE SIOUX FALLS, SD 57110 | AFLAC | $28 | — | $28 | 0.05% |
| LANCE E SULLIVAN3 | 3619 SANWOOD ST LAS VEGAS, NV 89147 | AFLAC | $28 | — | $28 | 0.05% |
| BETTY L RUSSOW3 | PO BOX 836 HOT SPRINGS, SD 57747 | AFLAC | $26 | — | $26 | 0.05% |
| THEODORE W HONKE3 | 40658 252ND ST MITCHELL, SD 57301 | AFLAC | $26 | — | $26 | 0.05% |
| JOLYNNE M MACK3 | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC | $20 | — | $20 | 0.04% |
| KATE PALCZEWSKI INC3 | 3412 CHISHOLM TRL BISMARCK, ND 58503 | AFLAC | $12 | $5 | $17 | 0.03% |
| JEREMY L TOMLINSON3 | 6305 W RUSSETT ST BOISE, ID 83704 | AFLAC | $17 | — | $17 | 0.03% |
| BRICE L CAMPBELL3 | 360 LIBERTY HEIGHTS DR CHASKA, MN 55318 | AFLAC | $14 | — | $14 | 0.03% |
| KEVIN C ARMSTRONG3 | 4027 WEST FAIDLEY AVE GRAND ISLAND, NE 68803 | AFLAC | $14 | — | $14 | 0.03% |
| AWS INC3 | 1919 WEST 57TH STREET. STE. 101 SIOUX FALLS, SD 57108 | AFLAC | $12 | — | $12 | 0.02% |
| ERIC GRAHAM3 | PO BOX 97 CASPER, WY 82602 | AFLAC | $12 | — | $12 | 0.02% |
| CSP INSURANCE AGENT INC3 | 2963 HIGHWAY 25 MANDAN, ND 58554 | AFLAC | $7 | $5 | $12 | 0.02% |
| SHON FORD LLC3 | 427 N BROADWAY AVE MILLER, SD 57362 | AFLAC | $11 | — | $11 | 0.02% |
| ASHLEY D WARNER3 | 712 2ND ST SW DE SMET, SD 57231 | AFLAC | $11 | — | $11 | 0.02% |
| BRADY WEISENBERGER3 | 4840 AMBER VALLEY PKWY S STE C FARGO, ND 58104 | AFLAC | $10 | — | $10 | 0.02% |
| WILLIAM W ARMSTRONG3 | P O BOX 448 OGALLALA, NE 69153 | AFLAC | $9 | — | $9 | 0.02% |
| BARRY CAMPBELL3 | 2798 COUNTRY ROAD 80 ALGER, OH 45812 | AFLAC | $8 | — | $8 | 0.01% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL D EVANS JR. | 3199 SIOUX CONIFER RD WATERTOWN, SD 57201 | AFLAC | $8 | — | $8 | 0.01% |
| MICHAEL A MAYER3 | 4406 CAMPOLINA LANE PASCO, WA 99301 | AFLAC | $8 | — | $8 | 0.01% |
| PERFORMANCE PLUS LLC3 | 114 N MAIN ST MITCHELL, SD 57301 | AFLAC | $7 | — | $7 | 0.01% |
| JAMES D NICHOL3 | 520 WELLINGTON COURT WEST FARGO, ND 58078 | AFLAC | $6 | — | $6 | 0.01% |
| CYNTHIA L SAMUELS3 | 3619 SANWOOD ST LAS VEGAS, NV 89147 | AFLAC | $6 | — | $6 | 0.01% |
| JOHN J FREDERICK3 | PO BOX 554, 8108 HIGHWAY 14 DAYTON, WY 82836 | AFLAC | $6 | — | $6 | 0.01% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AFLAC | $5 | — | $5 | 0.01% |
| PATSY ROBERTSON3 | PO BOX 438 NEW UNDERWOOD, SD 57761 | AFLAC | $5 | — | $5 | 0.01% |
| GARY WAYNE WILLINGHAM3 | 6033 STRAFFORD OAKS DR SEBRING, FL 33875 | AFLAC | $4 | — | $4 | 0.01% |
| CYNTHIA D WELKEN-PLACE3 | 601 CODY DR BISMARCK, ND 58503 | AFLAC | $3 | — | $3 | 0.01% |
| KAYLA ANN SCHAD3 | 4802 EDGEWOOD DR RAPID CITY, SD 57702 | AFLAC | $3 | — | $3 | 0.01% |
| WILLIAM M BARNETT3 Filed as: WILLIAM BARNETT | 703 NORTH SAGEHORN DR HARTFORD, SD 57033 | AFLAC | $1 | — | $1 | 0.00% |
| CORY L CAMPBELL3 Filed as: CORY CAMPBELL | 13139 FERRIS CT APPLE VALLEY, MN 55124 | AFLAC | $1 | — | $1 | 0.00% |
| CRAIG MICHELSEN3 | 426 TOPAZ DR SANTAQUIN, UT 84655 | AFLAC | $1 | — | $1 | 0.00% |
| FRANCES OSTERMEIER3 | 215 COLETON DR COPPERAS COVE, TX 76522 | AFLAC | $1 | — | $1 | 0.00% |
| JAMES PORTER3 | 223 STILLWATER CREEK DR BOZEMAN, MT 59718 | AFLAC | $1 | — | $1 | 0.00% |
| KARA M CARMODY3 | 718 HOYT AVE E ST ST PAUL, MN 55106 | AFLAC | $1 | — | $1 | 0.00% |
| LISA HALL3 | 2542 E SUNDOWN DR COEUR DALENE, ID 83815 | AFLAC | $1 | — | $1 | 0.00% |
| DAKOTACARE ADMINISTRATIVE SERVICES5 Filed as: DAKOTACARE ADMIN SERVICES INC | PO BOX 7406 SIOUX FALLS, SD 57117 | COMPANION LIFE INSURANCE COMPANY | $6K | — | $6K | 21.02% |
| SUMMIT REINSURANCE SERVICES INC | 7030 POINTE INVERNESS WAY STE 350 FORT WAYNE, IN 46804 | COMPANION LIFE INSURANCE COMPANY | $580 | — | $580 | 2.04% |
| SELECT NETWORKS5 | 317 6TH AVE. DES MOINES, IA 50309 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $953 | — | $953 | 10.16% |
| AZURANCE GROUP5 Filed as: AZURANCE GROUP INC | 4510 13TH AVE. S.W. FARGO, ND 58121 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $866 | — | $866 | 9.24% |
| DIRECT BENEFITS INC5 Filed as: DIRECT BENEFITS | 55 E 5TH ST ST. PAUL, MN 55101 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $520 | — | $520 | 5.55% |
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 | 64 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 65 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AFLAC | 60 | $55K |
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 160 | $71K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 44 | $9K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 303 | $28K |
| Stop-loss / reinsurancereinsurance | NATIONWIDE LIFE INSURANCE COMPANY | 66 | $429K |
| Other | COMPANION LIFE INSURANCE COMPANY | 303 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.