| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOEN & ASSOCIATES INC3 Filed as: BOEN AND ASSOCIATES, INC | 307 WEST 41ST STREET SIOUX FALLS, SD 57105 | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | $15K | — | $15K | 2.62% |
| BOEN & ASSOCIATES INC3 | PO BOX 89010 SIOUX FALLS, SD 57105 | UNION SECURITY INSURANCE COMPANY | $6K | — | $6K | 10.00% |
| MELODY B THOMPSON3 | 1206 MAIN AVENUE SOUTH BROOKINGS, SD 57006 | AFLAC | $1K | $20 | $1K | 7.66% |
| BOEN & ASSOCIATES INC3 Filed as: BOEN & ASSOCIATES | 307 WEST 41ST STREET SIOUX FALLS, SD 57105 | AFLAC | $592 | — | $592 | 4.01% |
| JADE COMPANIES LLC3 Filed as: JADE NELSON WITHERS | 1206 MAIN AVENUE SOUTH BROOKINGS, SD 57006 | AFLAC | $412 | $50 | $462 | 3.13% |
| TRACY L HOSTLER3 | 3500 S PHILLIPS AVENUE SUITE 101 SIOUX FALLS, SD 57105 | AFLAC | $283 | $20 | $303 | 2.05% |
| JESSICA FRINK3 | 3229 LINK DRIVE BISMARCK, ND 58503 | AFLAC | $261 | — | $261 | 1.77% |
| CAREN A STRAATMEYER3 Filed as: CAREN A STRATMEYER | 704 EAST 70TH PLACE SIOUX FALLS, SD 57108 | AFLAC | $193 | — | $193 | 1.31% |
| KIM R HARMS3 | PO BOX 184 COLMAN, SD 57017 | AFLAC | $187 | — | $187 | 1.27% |
| MICHAEL D EVANS JR3 | 113 5TH STREET SOUTHEAST WATERTOWN, SD 57201 | AFLAC | $60 | $20 | $80 | 0.54% |
| DAVID P AESOPH3 | 1301 SOUTH SUMMIT AVENUE SIOUX FALLS, SD 57105 | AFLAC | $77 | — | $77 | 0.52% |
| LISA K UHLIR3 | 8516 EAST WILLOW RIDGE PLACE SIOUX FALLS, SD 57110 | AFLAC | $74 | — | $74 | 0.50% |
| ELIZABETH A MEHLBRECH3 | 17500 25TH AVENUE NORTHEAST UNIT G301 MARYSVILLE, WA 98271 | AFLAC | $23 | $49 | $72 | 0.49% |
| KATE PALCZEWSKI INC3 | 3412 CHISHOLM TRAIL BISMARCK, ND 58503 | AFLAC | $54 | — | $54 | 0.37% |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD SUITE 140 BISMARCK, ND 58503 | AFLAC | $34 | — | $34 | 0.23% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DRIVE WATERTOWN, SD 57201 | AFLAC | $33 | — | $33 | 0.22% |
| WILLIAM D WENBERG3 | 13024 STACY LANE LITTLE ROCK, AR 72211 | AFLAC | $33 | — | $33 | 0.22% |
| KARLA R BYRUM3 | 6509 S VINTAGE PLACE SIOUX FALLS, SD 57108 | AFLAC | $27 | — | $27 | 0.18% |
| NAOMI C MCLAUGHLIN3 | 320 DEERVIEW AVENUE TEA, SD 57064 | AFLAC | $23 | — | $23 | 0.16% |
| ELIZABETH A MEHLBRECH3 | 704 SOUTH WHEATLAND AVENUE SIOUX FALLS, SD 57106 | AFLAC | $18 | — | $18 | 0.12% |
| MARY L SAVOLD3 | 2505 SOUTH KIWANIS AVENUE APARTMENT 146 SIOUX FALLS, SD 57105 | AFLAC | $15 | — | $15 | 0.10% |
| SARA KNEIP3 | 1218 6TH STREET BROOKINGS, SD 57006 | AFLAC | $12 | — | $12 | 0.08% |
| MICHAEL BOLGER3 | 128 WOODLAND DRIVE MADISON, SD 57042 | AFLAC | $10 | — | $10 | 0.07% |
| C SUE MCKENZIE3 | 20095 NORTH TEALSTONE DRIVE SURPRISE, AZ 85374 | AFLAC | $9 | — | $9 | 0.06% |
| MERLE D BIEBER3 | 13289 HENNING CIRCLE NORTHEAST PRIOR LAKE, MN 55372 | AFLAC | $5 | — | $5 | 0.03% |
| CHARLES L PRICE3 | 915 EAST DONEGAL STREET O NEILL, NE 68763 | AFLAC | $4 | — | $4 | 0.03% |
| BOEN & ASSOCIATES INC3 | 307 WEST 41ST STREET SIOUX FALLS, SD 57105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| BOEN & ASSOCIATES INC3 | 307 WEST 41ST STREET SIOUX FALLS, SD 57105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $910 | — | $910 | 10.00% |
| BOEN & ASSOCIATES INC3 | 307 WEST 41ST STREET SIOUX FALLS, SD 57105 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $282 | — | $282 | 10.01% |
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 | 102 | 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) | 102 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 88 | $583K |
| Dental | UNION SECURITY INSURANCE COMPANY | 66 | $63K |
| Vision | UNION SECURITY INSURANCE COMPANY | 66 | $63K |
| Life insurance(2 contracts, 2 carriers) | AFLAC | 100 | $18K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 24 | $9K |
| Other(3 contracts, 2 carriers) | AFLAC | 100 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 100 | — |
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.