| 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 | $14 | $4K | 7.81% |
| SUSAN M KAHN3 | 8625 CUT THROAT DRIVE BILLINGS, MT 59106 | AFLAC | $809 | $53 | $862 | — |
| JEANNE M HARTMAN3 | 39335 BROADLAND STREET HURON, SD 57350 | AFLAC | $755 | $56 | $811 | — |
| JOAN PATRICK3 | 3025 COUNTRY ROAD 139A MANDAN, ND 58554 | AFLAC | $253 | $69 | $322 | — |
| J KAUFMANN INSURANCE, INC3 Filed as: J KAUFMANN INSURANCE INC | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $256 | $11 | $267 | — |
| SHON FORD LLC3 Filed as: SHON S FORD | 427 NORTH BROADWAY AVENUE MILLER, SD 57362 | AFLAC | $219 | $11 | $230 | — |
| J THEIS & ASSOCIATES INC3 | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $161 | $11 | $172 | — |
| MELODY B THOMPSON3 | 1206 MAIN AVENUE SOUTH BROOKINGS, SD 57006 | AFLAC | $165 | — | $165 | — |
| JEREMY ALLEN TIMMERMANS3 | 1919 WEST 57TH STREET SUITE 101 SIOUX FALLS, SD 57108 | AFLAC | $128 | $11 | $139 | — |
| KATE PALCZEWSKI INC3 | 3412 CHISHOLM TRAIL BISMARCK, ND 58503 | AFLAC | $95 | $14 | $109 | — |
| CSP INSURANCE AGENT INC3 | 4207 BOULDER RIDGE ROAD SUITE 140 BISMARCK, ND 58503 | AFLAC | $52 | $14 | $66 | — |
| AWS INC3 | 1919 WEST 57TH STREET SUITE 101 SIOUX FALLS, SD 57108 | AFLAC | $57 | $2 | $59 | — |
| KARLA JEAN KENDRICK3 | 29009 199TH STREET PIERRE, SD 57501 | AFLAC | $45 | $7 | $52 | — |
| MICHAEL D EVANS JR3 | 113 5TH STREET SOUTHEAST WATERTOWN, SD 57201 | AFLAC | $47 | — | $47 | — |
| MARGARET A TURNER3 | 5201 SOUTH GLEN HAVEN PLACE SIOUX FALLS, SD 57108 | AFLAC | $44 | — | $44 | — |
| PEAK INC3 | 40658 252ND STREET MITCHELL, SD 57301 | AFLAC | $43 | — | $43 | — |
| TRACY L HOSTLER3 | 3922 SOUTH WESTERN AVENUE SIOUX FALLS, SD 57105 | AFLAC | $37 | — | $37 | — |
| RUSSELL C MOLSTAD JR3 | 3409 WEST MAIN STREET RAPID CITY, SD 57703 | AFLAC | $34 | — | $34 | — |
| SHON FORD LLC3 | 427 NORTH BROADWAY AVENUE MILLER, SD 57362 | AFLAC | $26 | — | $26 | — |
| ELLIE PAPINEAU LLC3 | 2898 5TH AVENUE WEST DICKINSON, ND 58601 | AFLAC | $24 | — | $24 | — |
| NAOMI C MCLAUGHLIN3 Filed as: NAOMI MCLAUGHLIN | 320 DEERVIEW AVENUE TEA, SD 57064 | AFLAC | $24 | — | $24 | — |
| SHAWN D BENSER3 | 4840 AMBER VALLEY PARKWAY SUITE C FARGO, ND 58104 | AFLAC | $21 | — | $21 | — |
| KATHLEEN K JOHNSON3 | 610 27TH STREET WEST DICKINSON, ND 58601 | AFLAC | $19 | — | $19 | — |
| AMBER MARIE LIND3 | 3409 WEST MAIN STREET RAPID CITY, SD 57702 | AFLAC | $18 | — | $18 | — |
| EUGENE BUTCH LINSTER3 | 3611 ANGEL WAY RAPID CITY, SD 57703 | AFLAC | $16 | — | $16 | — |
| DAVID P AESOPH3 | 2700 WEST NICOLE DRIVE SIOUX FALLS, SD 57105 | AFLAC | $15 | — | $15 | — |
| BETTY L RUSSOW3 | PO BOX 836 HOT SPRINGS, SD 57747 | AFLAC | $14 | — | $14 | — |
| AMANDA JACKSON3 | 1465 ROUGHRIDER BOULEVARD APARTMENT D302 DICKINSON, ND 58601 | AFLAC | $13 | — | $13 | — |
| BRADY L WEISENBERGER3 | 4840 AMBER VALLEY PARKWAY SOUTH SUITE C FARGO, ND 56104 | AFLAC | $12 | — | $12 | — |
| JOLYNNE M MACK3 | 113 5TH STREET SOUTHEAST WATERTOWN, SD 57201 | AFLAC | $12 | — | $12 | — |
| SARA KNEIP3 | 1218 6TH STREET BROOKINGS, SC 57006 | AFLAC | $12 | — | $12 | — |
| NICHOLE L EGEBERG BERNSDORF3 Filed as: NICHOLE EGEBERG BERNSDORF | PO BOX 297 900 JOHNSON STREET BURLINGTON, ND 58722 | AFLAC | $12 | — | $12 | — |
| TED HONKE3 | 40658 252ND STREET MITCHELL, SD 57301 | AFLAC | $10 | — | $10 | — |
| KEVIN B VINING3 | 24747 HIDDEN VALLEY ROAD HERMOSA, SD 57744 | AFLAC | $10 | — | $10 | — |
| LISA HALL3 | 2542 EAST SUNDOWN DRIVE COEUR D ALENE, ID 83815 | AFLAC | $9 | — | $9 | — |
| MICHAEL D EVANS JR3 Filed as: MICHAEL J TOMLINSON | 40 PARADISE DRIVE WATERTOWN, SD 57201 | AFLAC | $7 | — | $7 | — |
| RHONDA WENBERG3 | 3 BENT TREE DRIVE LITTLE ROCK, AR 72212 | AFLAC | $6 | — | $6 | — |
| CRAIG MICHELSEN3 | 1228 25TH AVENUE SOUTHWEST GREAT FALLS, MT 59404 | AFLAC | $4 | — | $4 | — |
| CRAIG S STADTFELD3 | 1919 WEST 57TH STREET SUITE 101 SIOUX FALLS, SD 57108 | AFLAC | $4 | — | $4 | — |
| GERALD R THEIS JR3 | 2048 OVERLAND AVENUE SUITE 202 BILLINGS, MT 59102 | AFLAC | $4 | — | $4 | — |
| JAMES PORTER3 | 223 STILLWATER CREEK DRIVE BOZEMAN, MT 59718 | AFLAC | $3 | — | $3 | — |
| DAWN D SHEUE3 Filed as: DAWN SHEUE | PO BOX 3986 JACKSON, WY 83001 | AFLAC | $1 | — | $1 | — |
| CASEY DALE HOBSON3 | 13320 WEST REDWICK DRIVE BOISE, ID 83713 | AFLAC | $1 | — | $1 | — |
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 | 90 | 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) | 90 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 66 | $614K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 90 | $55K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 90 | $55K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 90 | $55K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 90 | $55K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 90 | — |
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.