| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE, SUITE 100 BLOOMINGTON, MN 55437 | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | $40K | — | $40K | 2.50% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $11K | $0 | $11K | 9.44% |
| AZURANCE GROUP3 Filed as: AZURANCE GROUP, INC. | 4510 13TH AVENUE SW FARGO, ND 58121 | USABLE LIFE | $230 | $0 | $230 | 4.70% |
| LOLANDA GORZE3 | 600 21ST STREET NW MINOT, ND 58703 | USABLE LIFE | $27 | $0 | $27 | 0.55% |
| JULIE SLAUGHTER3 Filed as: JULIE SCHIRADO | 2500 14TH AVENUE SE MANDAN, ND 58554 | USABLE LIFE | $5 | $0 | $5 | 0.10% |
| MILISSA VAN EPS3 | 1223 RHINEHART DRIVE SE WAHPETON, ND 58075 | USABLE LIFE | $4 | $0 | $4 | 0.08% |
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 | 124 | 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) | 124 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 201 | $1.6M |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $119K |
| Vision | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $119K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $119K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $119K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF NORTH DAKOTA | 201 | $1.6M |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.