Form 5500 · Employee benefit plan · DEVILS LAKE, ND
WESTERN STATE AGENCY INC
WESTERN STATE AGENCY INC of DEVILS LAKE, ND files a Form 5500 with the U.S. Department of Labor disclosing its employee benefit plan. Its broker of record is BROWN & BROWN OF MINNESOTA, INC.. Coverage is written through HARTFORD LIFE AND ACCIDENT and 3 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 45-6016570 · plan 505 · as of Aug 2026
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| HARTFORD LIFE AND ACCIDENT | Life, Disability | 341 | December | $228,524 | $29,657 |
| DELTA DENTAL OF MINNESOTA | Dental | 583 | December | $298,723 | $27,207 |
| EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | Vision | 550 | December | $33,386 | $4,077 |
| KEPRO | — | 282 | December | $9,535 | $0 |
Questions
Who is WESTERN STATE AGENCY INC's benefits broker?
Per its most recent Form 5500 Schedule A, WESTERN STATE AGENCY INC's broker of record is BROWN & BROWN OF MINNESOTA, INC..
What insurance carrier does WESTERN STATE AGENCY INC use?
WESTERN STATE AGENCY INC's benefit plan is written through HARTFORD LIFE AND ACCIDENT, among 4 disclosed carriers.
When does WESTERN STATE AGENCY INC's group plan renew?
The most recent Schedule A policy period for WESTERN STATE AGENCY INC ended in December. Group plans typically renew on the same annual cycle.
Where does this data come from?
All figures are drawn from WESTERN STATE AGENCY INC's public Form 5500 filing with the U.S. Department of Labor (EFAST2). Form 5500 is a public record.