| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| AZURANCE GROUP | 4510 13TH AVE SW FARGO, ND 58121 | GUARDIAN | $18K | — | $18K | 8.64% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRIME THERAPEUTICS | Other fees Service code 99 | 1305 CORPORATE CENTER DRIVE EAGAN, MN 55121 | $0 |
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 | 146 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 199 | $1.2M |
| Dental | GUARDIAN | 146 | $207K |
| Vision | GUARDIAN | 146 | $207K |
| Life insurance | GUARDIAN | 146 | $207K |
| Short-term disability | GUARDIAN | 146 | $207K |
| Long-term disability | GUARDIAN | 146 | $207K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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.