| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WORTHAM SAN ANTONIO INC Filed as: JOHN WEST | — | SANFORD HEALTH PLAN | $17K | — | $17K | 1.77% |
| JAMES ALAN HEYN3 Filed as: JAMES HEYN | 1296 S LAKE DR WATERTOWN, SD 57201 | AFLAC | $13K | $767 | $14K | 7.61% |
| THOMAS JENSEN3 | 907 S 5TH ST MILBANK, SD 57252 | AFLAC | $4K | $229 | $4K | 2.13% |
| MONICA ANN MAHOWALD3 | 907 S 5TH ST MILBANK, SD 57252 | AFLAC | $3K | $173 | $3K | 1.88% |
| SHON FORD LLC3 | 427 N BROADWAY AVE MILLER, SD 57362 | AFLAC | $3K | $223 | $3K | 1.65% |
| CAROLYN MAE AMMANN3 Filed as: CAROLYN AMMANN | 2013 PALISADES LN WATERTOWN, SD 57201 | AFLAC | $2K | — | $2K | 1.16% |
| NEFZGER ENTERPRISES INC3 | 524 WEST LAKE DR LAKE NORDEN, SD 57248 | AFLAC | $1K | $38 | $1K | 0.82% |
| BRIAN LEE FREEMAN3 | PO BOX 178 1111 6TH ST BRITTON, SD 57430 | AFLAC | $947 | — | $947 | 0.53% |
| LANCE D THORSON3 Filed as: LANCE THORSON | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC | $775 | — | $775 | 0.43% |
| ERICCA J PAUL3 | 807 W 1ST AVE MILLER, SD 57362 | AFLAC | $677 | — | $677 | 0.38% |
| JEREMY L TOMLINSON3 Filed as: JEREMY TOMLINSON | 2805 N 36TH ST BOISE, ID 83703 | AFLAC | $526 | — | $526 | 0.29% |
| PEAK INC3 | 40658 252ND ST MITCHELL, SD 57301 | AFLAC | $504 | — | $504 | 0.28% |
| CLAIRE FRAZEE3 | 15274 477TH AVE MILBANK, SD 57252 | AFLAC | $432 | — | $432 | 0.24% |
| TERRY WILLIAM ULRICH3 | 2226 PALISADES LN WATERTOWN, SD 57201 | AFLAC | $428 | — | $428 | 0.24% |
| JOSEPH DUDLEY KNIGHT3 | 705 7TH AVE S CLEAR LAKE, SD 57226 | AFLAC | $386 | $10 | $396 | 0.22% |
| JOLYNNE M MACK3 Filed as: JOLYNNE MACK | 113 5TH STREET SE WATERTOWN, SD 57201 | AFLAC | $377 | — | $377 | 0.21% |
| DALTON JAMES ENG3 | 206 E KEMP AVE WATERTOWN, SD 57201 | AFLAC | $372 | — | $372 | 0.21% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL EVANS JR | 113 5TH ST SE WATERTOWN, SD 57201 | AFLAC | $356 | — | $356 | 0.20% |
| KRISTI ENDRES3 | 1305 22ND ST NE WATERTOWN, SD 57201 | AFLAC | $249 | $103 | $352 | 0.20% |
| MARY C SIMINOVSKY3 | 220 W 6TH AVE APT 1 MILBANK, SD 57252 | AFLAC | $253 | — | $253 | 0.14% |
| NAOMI C MCLAUGHLIN3 Filed as: NAOMI MCLAUGHLIN | 320 DEERVIEW AVE TEA, SD 57064 | AFLAC | $225 | — | $225 | 0.13% |
| NAOMI K DEMPCY3 | 416 5TH ST. WEST MADISON, MN 56256 | AFLAC | $104 | $49 | $153 | 0.09% |
| MICHAEL C WALKER3 Filed as: MICHAEL TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC | $139 | — | $139 | 0.08% |
| SHON FORD LLC3 Filed as: SHON FORD | 427 N BROADWAY AVE MILLER, SD 57362 | AFLAC | $124 | $10 | $134 | 0.08% |
| JASON MACK3 | 1623 7TH ST NE WATERTOWN, SD 57201 | AFLAC | $129 | $1 | $130 | 0.07% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $122 | — | $122 | 0.07% |
| SHIRLEY WYMAN3 | 1120 N 3RD ST WAUBAY, SD 57273 | AFLAC | $101 | — | $101 | 0.06% |
| TRAVIS RONKE3 | 102 8TH ST NW WATERTOWN, SD 57201 | AFLAC | $81 | — | $81 | 0.05% |
| LISA K UHLIR3 Filed as: LISA UHLIR | 8516 E WILLOW RIDGE PLACE SIOUX FALLS, SD 57110 | AFLAC | $65 | — | $65 | 0.04% |
| BRADY WEISENBERGER3 | 4840 AMBER VALLEY PKWY S STE C FARGO, ND 58104 | AFLAC | $40 | — | $40 | 0.02% |
| SCOTT E PFAFF3 Filed as: SCOTT PFAFF | 2201 ASH AVE NE WATERTOWN, SD 57201 | AFLAC | $39 | — | $39 | 0.02% |
| ROBIN NEFZGER3 | 524 WEST LAKE DRIVE LAKE NORDEN, SD 57248 | AFLAC | $26 | — | $26 | 0.01% |
| JONNELL P ACKELSON3 Filed as: JONNELL ACKELSON | 31250 N AVE ADEL, IA 50003 | AFLAC | $25 | — | $25 | 0.01% |
| ROBERT WATKINS3 | PO BOX 14 BRITTON, SD 57430 | AFLAC | $22 | — | $22 | 0.01% |
| HEATHER M BRAMER3 Filed as: HEATHER BRAMER | 808 S MAPLE WATERTOWN, SD 57201 | AFLAC | $21 | — | $21 | 0.01% |
| WILLIAM D WENBERG3 Filed as: WILLIAM WENBERG | 13024 STACY LANE LITTLE ROCK, AR 72211 | AFLAC | $21 | — | $21 | 0.01% |
| ANNE E MACK3 Filed as: ANNE MACK | 1623 7TH ST NE WATERTOWN, SD 57201 | AFLAC | $18 | — | $18 | 0.01% |
| CONNIE SCHWEITZER3 | 918 S 1ST ST ABERDEEN, SD 57401 | AFLAC | $18 | — | $18 | 0.01% |
| JENNIFER SANDAL3 | 43755 122ND ST EDEN, SD 57232 | AFLAC | $16 | — | $16 | 0.01% |
| JUSTINE DEVILLE3 | 5514 7TH AVENUE SW WATERTOWN, SD 57201 | AFLAC | $11 | — | $11 | 0.01% |
| DAVID J MCCLELLAN3 Filed as: DAVID AESOPH | 2700 W NICOLE DR SIOUX FALLS, SD 57105 | AFLAC | $9 | — | $9 | 0.01% |
| ASHLEY BENNETT LLC3 | 16 2ND AVE SW ABERDEEN, SD 57401 | AFLAC | $9 | — | $9 | 0.01% |
| SHAWN D BENSER3 Filed as: SHAWN BENSER | 4840 AMBER VALLEY PKWY S STE C FARGO, ND 58104 | AFLAC | $8 | — | $8 | 0.00% |
| SARAH SUTTON3 | 1618 8TH ST NE WATERTOWN, SD 57201 | AFLAC | $4 | $2 | $6 | 0.00% |
| RONDA ROSE-KAYSER3 | 2320 SIENNA CIR TEA, SD 57064 | AFLAC | $6 | — | $6 | 0.00% |
| TED HONKE3 | 40658 252ND ST MITCHELL, SD 57301 | AFLAC | $5 | — | $5 | 0.00% |
| NANCY R VANDENBERGE3 | 5209 S SAND CHERRY CIR SIOUX FALLS, SD 57108 | AFLAC | $5 | — | $5 | 0.00% |
| KARA M CARMODY3 Filed as: KARA CARMODY | 718 HOYT AVE E. ST ST. PAUL, MN 55106 | AFLAC | $4 | — | $4 | 0.00% |
| SARA KNEIP3 | 1218 6TH STREET BROOKINGS, SD 57006 | AFLAC | $3 | — | $3 | 0.00% |
| WILLIAM M BARNETT3 Filed as: WILLIAM BARNETT | 703 NORTH SAGEHORN DRIVE HARTFORD, SD 57033 | AFLAC | $2 | — | $2 | 0.00% |
| TRACY L HOSTLER3 | 3922 S WESTERN AVE SIOUX FALLS, SD 57105 | AFLAC | $2 | — | $2 | 0.00% |
| KEVIN DAVID GLEASON3 | 7001 S LYNCREST PL STE 102 SIOUX FALLS, SD 571082964 | PRINCIPAL LIFE INSURANCE COMPANY | $3K | — | $3K | 14.43% |
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 | 275 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 275 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | SANFORD HEALTH PLAN | 275 | $1.1M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 121 | $19K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 275 | — |
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."
No prospect flags tripped on this filing.