| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WESTERN BENEFITS GROUP INC3 | PO BOX 8124 RAPID CITY, SD 57709 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $67K | $20K | $87K | 3.25% |
| WELLMARK INC3 Filed as: WELLMARK BCBS | 1601 W MADISON ST PO BOX 5023 SIOUX FALLS, SD 57117 | DELTA DENTAL OF SOUTH DAKOTA | $2K | — | $2K | — |
| WELLMARK INC3 Filed as: WELLMARK BCBS | 1601 W MADISON ST PO BOX 5023 SIOUX FALLS, SD 57117 | DELTA DENTAL OF SOUTH DAKOTA | $359 | — | $359 | — |
| WELLMARK INC3 Filed as: WELLMARK BCBS | 1601 W MADISON STREET PO BOX 5023 SIOUX FALLS, SD 57117 | DELTA DENTAL OF SOUTH DAKOTA | $26 | — | $26 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| DELOITTE & TOUCHE LLP EIN 13-3891517 NONE | Accounting (including auditing); Direct payment from the plan Service code 10 | — | $25K |
| WELLS FARGO EIN 94-1347393 TRUSTEE | Direct payment from the plan; Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $4K |
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 | 292 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 212 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 504 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 2,016 | $31.0M |
| Dental(3 contracts) | DELTA DENTAL OF SOUTH DAKOTA | 5,029 | $0 |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,620 | $2.8M |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,620 | $2.7M |
| Prescription drug | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 2,016 | $31.0M |
| Stop-loss / reinsurancereinsurance | WELLMARK BLUE CROSS AND BLUE SHIELD OF SOUTH DAKOTA | 2,016 | $31.0M |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 4,620 | $2.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,029 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.