| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | PO BOX 1237 GLASTONBURY, CT 06033 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $215 | $3K | 5.41% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $751 | $0 | $751 | 1.54% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET #700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $404 | $19 | $423 | 0.86% |
| EMPLOYEE FAMILY PROTECTION INC3 Filed as: EMPLOYEE FAMILY PROTECTION, INC. | PO BOX 1237 GLASTONBURY, CT 06033 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $65 | $2K | 5.56% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $275 | $11 | $286 | 1.04% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS PORTLAND | 4565 PAYSPHERE CIR CHICAGO, IL 60674 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $188 | — | $188 | 0.69% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 10.01% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $283 | $2K | 17.00% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $178 | $2K | 17.01% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF NORTH AMERICA | $655 | $131 | $786 | 12.01% |
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 | 280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 166 | $21K |
| Life insurance(3 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 280 | $70K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 124 | $49K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 15 | $9K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 280 | $48K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.