| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BOEN & ASSOCIATES INC3 | 307 WEST 41ST STREET PO BOX 89010 SIOUX FALLS, SD 57105 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | — | $4K | 7.70% |
| JEANNE M HARTMAN3 | 39335 BROADLAND STREET HURON, SD 57350 | AFLAC | $1K | $12 | $1K | 4.34% |
| JOAN PATRICK3 | 3025 COUNTRY ROAD 139A MANDAN, ND 58554 | AFLAC | $887 | $11 | $898 | 3.67% |
| SUSAN M KAHN3 | 8625 CUT THROAT DRIVE BILLINGS, MT 59106 | AFLAC | $780 | $28 | $808 | 3.30% |
| KATE PALCZEWSKI INC3 | 3412 CHISHOLM TRAIL BISMARCK, ND 58503 | AFLAC | $232 | $2 | $234 | 0.96% |
| J KAUFMANN INSURANCE, INC3 Filed as: J KAUFMANN INSURANCE INC | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $216 | $6 | $222 | 0.91% |
| SHON FORD LLC3 Filed as: SHON S FORD | 427 NORTH BROADWAY AVENUE MILLER, SD 57362 | AFLAC | $175 | $3 | $178 | 0.73% |
| J THEIS & ASSOCIATES INC3 | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $156 | $6 | $162 | 0.66% |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD SUITE 140 BISMARCK, ND 58503 | AFLAC | $155 | $2 | $157 | 0.64% |
| MELODY B THOMPSON3 | 1206 MAIN AVENUE SOUTH BROOKINGS, SD 57006 | AFLAC | $153 | — | $153 | 0.63% |
| SHON FORD LLC3 | 427 NORTH BROADWAY AVENUE MILLER, SD 57362 | AFLAC | $130 | — | $130 | 0.53% |
| MELISSA STUART INC3 | 4122 OVERLAND ROAD BISMARCK, ND 58503 | AFLAC | $108 | — | $108 | 0.44% |
| KARLA JEAN KENDRICK3 | 29009 199TH STREET PIERRE, SD 57501 | AFLAC | $91 | — | $91 | 0.37% |
| JEREMY ALLEN TIMMERMANS3 | 1919 WEST 57TH STREET SUITE 101 SIOUX FALLS, SD 57108 | AFLAC | $84 | — | $84 | 0.34% |
| PEAK INC3 | 1130 SOUTH BURR SUITE 300 PO BOX 514 MITCHELL, SD 57301 | AFLAC | $60 | — | $60 | 0.25% |
| AWS INC3 | 1919 WEST 57TH STREET SUITE 101 SIOUX FALLS, SD 57108 | AFLAC | $53 | — | $53 | 0.22% |
| MICHAEL D EVANS JR3 | 113 5TH STREET SOUTHEAST WATERTOWN, SD 57201 | AFLAC | $49 | — | $49 | 0.20% |
| MARGARET A TURNER3 | 5201 SOUTH GLEN HAVEN PLACE SIOUX FALLS, SD 57108 | AFLAC | $46 | — | $46 | 0.19% |
| TRACY L HOSTLER3 | 3922 SOUTH WESTERN AVENUE SIOUX FALLS, SD 57105 | AFLAC | $35 | — | $35 | 0.14% |
| RUSSELL C MOLSTAD JR3 | 3409 WEST MAIN STREET RAPID CITY, SD 57703 | AFLAC | $34 | — | $34 | 0.14% |
| SCOTT L WOODSON3 | 816 SOUTH 31ST STREET BILLINGS, MT 59101 | AFLAC | $27 | — | $27 | 0.11% |
| ELLIE PAPINEAU LLC3 | 2898 5TH AVENUE WEST DICKINSON, ND 58601 | AFLAC | $24 | — | $24 | 0.10% |
| NAOMI C MCLAUGHLIN3 Filed as: NAOMI MCLAUGHLIN | 320 DEERVIEW AVENUE TEA, SD 57064 | AFLAC | $24 | — | $24 | 0.10% |
| SHAWN D BENSER3 | 4840 AMBER VALLEY PARKWAY SUITE C FARGO, ND 58104 | AFLAC | $21 | — | $21 | 0.09% |
| KATHLEEN K JOHNSON3 | 610 27TH STREET WEST DICKINSON, ND 58601 | AFLAC | $19 | — | $19 | 0.08% |
| AMBER MARIE LIND3 | 3409 WEST MAIN STREET RAPID CITY, SD 57702 | AFLAC | $18 | — | $18 | 0.07% |
| KRISTIE L NOSBISH3 | 1909 31ST AVENUE SOUTHWEST APARTMENT 313 MINOT, ND 58701 | AFLAC | $16 | — | $16 | 0.07% |
| EUGENE BUTCH LINSTER3 | 3611 ANGEL WAY RAPID CITY, SD 57703 | AFLAC | $16 | — | $16 | 0.07% |
| DAVID P AESOPH3 | 2700 WEST NICOLE DRIVE SIOUX FALLS, SD 57105 | AFLAC | $15 | — | $15 | 0.06% |
| BETTY L RUSSOW3 | PO BOX 836 HOT SPRINGS, SD 57747 | AFLAC | $14 | — | $14 | 0.06% |
| BRADY L WEISENBERGER3 | 4840 AMBER VALLEY PARKWAY SOUTH SUITE C FARGO, ND 56104 | AFLAC | $14 | — | $14 | 0.06% |
| MELODY B THOMPSON3 | 1206 MAIN AVENUE SOUTH BROOKINGS, SD 57006 | AFLAC | $14 | — | $14 | 0.06% |
| AMANDA JACKSON3 | 1465 ROUGHRIDER BOULEVARD APARTMENT D302 DICKINSON, ND 58601 | AFLAC | $13 | — | $13 | 0.05% |
| JOLYNNE M MACK3 | 113 5TH STREET SOUTHEAST WATERTOWN, SD 57201 | AFLAC | $13 | — | $13 | 0.05% |
| SARA KNEIP3 | 1218 6TH STREET BROOKINGS, SC 57006 | AFLAC | $12 | — | $12 | 0.05% |
| NICHOLE L EGEBERG BERNSDORF3 Filed as: NICHOLE EGEBERG BERNSDORF | PO BOX 297 900 JOHNSON STREET BURLINGTON, ND 58722 | AFLAC | $11 | — | $11 | 0.04% |
| LISA HALL3 | 2542 EAST SUNDOWN DRIVE COEUR D ALENE, ID 83815 | AFLAC | $11 | — | $11 | 0.04% |
| TED HONKE3 | 1130 SOUTH BURR SUITE 200 PO BOX 514 MITCHELL, SD 57301 | AFLAC | $10 | — | $10 | 0.04% |
| KEVIN B VINING3 | 24747 HIDDEN VALLEY ROAD HERMOSA, SD 57744 | AFLAC | $10 | — | $10 | 0.04% |
| MICHAEL D EVANS JR3 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DRIVE WATERTOWN, SD 57201 | AFLAC | $8 | — | $8 | 0.03% |
| WILLIAM D WENBERG3 | 130247 STACY LANE LITTLE ROCK, AR 72211 | AFLAC | $6 | — | $6 | 0.02% |
| CRAIG MICHELSEN3 | 1228 25TH AVENUE SOUTHWEST GREAT FALLS, MT 59404 | AFLAC | $5 | — | $5 | 0.02% |
| CRAIG S STADTFELD3 | 1919 WEST 57TH STREET SUITE 101 SIOUX FALLS, SD 57108 | AFLAC | $4 | — | $4 | 0.02% |
| HEIDI ALFSON3 | 602 IRONWOOD DRIVE HARTFORD, SD 57033 | AFLAC | $3 | — | $3 | 0.01% |
| ADELINE PELSTER3 | 3113 EDGEWOOD POINT BISMARCK, ND 58503 | AFLAC | $3 | — | $3 | 0.01% |
| JAMES PORTER3 | 223 STILLWATER CREEK DRIVE BOZEMAN, MT 59718 | AFLAC | $3 | — | $3 | 0.01% |
| DAWN D SHEUE3 Filed as: DAWN SHEUE | PO BOX 3986 JACKSON, WY 83001 | AFLAC | $3 | — | $3 | 0.01% |
| TRACY L HOSTLER3 | 3500 SOUTH PHILLIPS AVENUE SUITE 101 SIOUX FALLS, SD 57105 | AFLAC | $3 | — | $3 | 0.01% |
| JEREMY L TOMLINSON3 | 2249 WEST RIDENBAUGH STREET BOISE, ID 83702 | AFLAC | $2 | — | $2 | 0.01% |
| GERALD R THEIS JR3 | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $2 | — | $2 | 0.01% |
| CASEY DALE HOBSON3 | 13320 WEST REDWICK DRIVE BOISE, ID 83713 | AFLAC | $1 | — | $1 | 0.00% |
| GERALD R THEIS JR3 | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $1 | — | $1 | 0.00% |
| NICOLE BERNSDORF3 Filed as: NICOLE L EGEBERG BERNSDORF | PO BOX 297 900 JOHNSON STREET BURLINGTON, ND 58722 | AFLAC | $1 | — | $1 | 0.00% |
| WILLIAM M BARNETT3 | 703 NORTH SAGEHORN DRIVE HARTFORD, SD 57033 | AFLAC | $1 | — | $1 | 0.00% |
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 | 85 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 87 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 64 | $620K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 147 | $56K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 147 | $56K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 147 | $56K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 147 | $80K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.