| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | — | HARVARD PILGRIM HEALTH CARE | $27K | — | $27K | 0.70% |
| HAYS COMPANIES, INC.3 Filed as: HAYS INSURANCE BROKERAGE GRP OF NE | — | HARVARD PILGRIM HEALTH CARE | $4K | — | $4K | 0.79% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH EIGHTH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $21K | — | $21K | 4.97% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $11K | $14K | $25K | 22.16% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE, #1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $95 | $95 | 0.08% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $25 | $25 | 0.02% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 10.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $853 | — | $853 | 10.00% |
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 | 394 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 398 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | HARVARD PILGRIM HEALTH CARE | 494 | $4.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 323 | $425K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 394 | $113K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 391 | $73K |
| Other(2 contracts) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 394 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 494 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.