| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOEN & ASSOCIATES INC3 Filed as: BOEN & ASSOCIATES | 307 W 41ST ST SIOUX FALLS, SD 57105 | SANFORD HEALTH PLAN | $25K | — | $25K | 62.50% |
| KELLI POTTER3 | 106 E BEEBE AVE CHAMBERLAIN, SD 57325 | KANSAS CITY LIFE INSURANCE COMPANY | $4K | — | $4K | 10.08% |
| AZIZ ELMAMOUNI3 | 821 N HUDSON AVE SIOUX FALLS, SD 57104 | OPTILEGRA | $2K | — | $2K | 6.94% |
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 | 131 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 136 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 274 | $90K |
| Vision | OPTILEGRA | 72 | $28K |
| Life insurance | KANSAS CITY LIFE INSURANCE COMPANY | 131 | $38K |
| Stop-loss / reinsurancereinsurance | SANFORD HEALTH PLAN | 151 | $40K |
| Other | KANSAS CITY LIFE INSURANCE COMPANY | 131 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 274 | — |
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.