| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP OF WI LLC | 1200 N MAYFAIR RD MILWAUKEE, WI 53226 | EYE MED | $2K | — | $2K | 9.94% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Float revenue; Other fees Service code 12 | — | $655K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $112K |
| HAYS COMPANIES OF WI EIN 41-1932108 BROKER | Other commissions Service code 55 | — | $37K |
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 | 322 | 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) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYE MED | 322 | $22K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $30K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 124 | $12K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 280 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.