Form 5500 · Employee benefit plan · FARGO, ND
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA
The filing calls this plan GROUP LIFE INSURANCE PROGRAM.
BLUE CROSS BLUE SHIELD OF NORTH DAKOTA of FARGO, ND is a 900-participant finance and insurance employer whose group benefits are disclosed in its annual Form 5500 filing. Its broker of record is AZURANCE GROUP, INC.. Coverage is written through UNUM LIFE INSURANCE COMPANY OF AMERICA. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-0173185 · plan 502 · plan year 2024, filed Sep 30, 2025
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How this plan is funded
Funding not settled by the filing
The filing does not report enough to settle how this plan pays for benefits.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 2 insured contracts covering life and disability; the largest, with UNUM LIFE INSURANCE COMPANY OF AMERICA, covers 5,713 people.
Reported premium is $2,818,930; the filing discloses no broker commission on these contracts.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
AZURANCE GROUP, INC. is the broker of record on all 2 contracts.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 5,713 | Jan 1, 2025 | $2,113,246 | $0 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 1,178 | Jan 1, 2025 | $705,684 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
Other plans filed by this employer
How this plan compares
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