| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $166 | $6K | 8.30% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLGHER BENEFIT SERVICES INC | 116 HUNTINGTON AVENUE 10TH FLOOR BOSTON, MA 02116 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3K | $110 | $3K | 7.09% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 116 HUNTINGTON AVE 10TH FLOOR BOSTON, MA 02116 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $4K | $99 | $4K | 10.24% |
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP, INC. | 133 FEDERAL STREET, 3RD FLOOR BOSTON, MA 02110 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH, PA | $150 | — | $150 | 15.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | NBC 88 P.O. BOX 1414 MINNEAPOLIS, MN 55480 | DELTA DENTAL OF MASSACHUSETTS | $8K | — | $8K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE BENEFIT ADMINISTRATORS CONTRACT ADMIN | Plan Administrator; Claims processing; Contract Administrator Service code 12 | PO BOX 55917 BOSTON, MA 02205 | $265K |
| DELTA DENTAL DENTAL ADMIN | Insurance services; Contract Administrator; Claims processing Service code 12 | 465 MEDFORD STREET BOSTON, MA 02129 | $49K |
| THE HAYS GROUP INC CONSULTANT | Consulting (general) Service code 16 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | $38K |
| PAYFLEX SYSTEMS USA, INC. FSA ADMIN | Contract Administrator; Claims processing Service code 12 | 10802 FARNAM DRIVE OMAHA, NE 68154 | $6K |
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 | 367 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 379 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MASSACHUSETTS | 772 | $0 |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 367 | $44K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 367 | $67K |
| Other(4 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 367 | $102K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 772 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.