| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS | 1300 WEST 57TH STREET, SUITE 101 SIOUX FALLS, SD 57108 | DELTA DENTAL OF SOUTH DAKOTA | $5K | $0 | $5K | 1.18% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS | 1300 WEST 57TH STREET SIOUX FALLS, SD 57108 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $26K | $0 | $26K | 14.92% |
| JANET H BOHNE3 Filed as: JANET H. BOHNE | 4510 SHERIDAN LAKE ROAD RAPID CITY, SD 57702 | AFLAC | $3K | $145 | $3K | 5.82% |
| KAYLA ANN SCHAD3 | 3409 WEST MAIN STREET RAPID CITY, SD 57702 | AFLAC | $738 | $26 | $764 | 1.64% |
| SHAWN D BENSER3 Filed as: SHAWN D. BENSER AND OTHER AGENTS | 4840 AMBER VALLEY PARKWAY SOUTH SUITE C FARGO, ND 58104 | AFLAC | $674 | $0 | $674 | 1.44% |
| AMBER MARIE LIND3 | 3409 WEST MAIN STREET RAPID CITY, SD 57702 | AFLAC | $529 | $26 | $555 | 1.19% |
| GUENOT ENTERPRISES INC3 | 1501 CENTRE STREET, SUITE 101 RAPID CITY, SD 57703 | AFLAC | $323 | $0 | $323 | 0.69% |
| SHIVANI PATEL3 | 3806 MEADOWBROOK DRIVE RAPID CITY, SD 57702 | AFLAC | $171 | $0 | $171 | 0.37% |
| STEPHEN C JONES3 Filed as: STEPHEN C. JONES | PO BOX 17284 MISSOULA, MT 59808 | AFLAC | $149 | $0 | $149 | 0.32% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL GREAT PLAINS LLC | 11516 MIRACLE HILLS DRIVE SUITE 105 OMAHA, NE 68154 | VISION SERVICE PLAN | $2K | $0 | $2K | 3.88% |
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 | 333 | 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) | 338 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF SOUTH DAKOTA | 739 | $389K |
| Vision | VISION SERVICE PLAN | 244 | $45K |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $224K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $177K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $177K |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 326 | $224K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 739 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.