| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | ALTUS DENTAL INSURANCE CO, INC. | $10K | — | $10K | 3.95% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | ALTUS DENTAL INSURANCE CO, INC. | $139 | — | $139 | 0.05% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC DBA CSONE | 2 DELTA DRIVE, SUITE 301 6TH FL CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | $3K | $13K | 6.80% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $5K | $10K | 5.53% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $7K | $4K | $11K | 6.95% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC DBA CSONE | 2 DELTA DRIVE, SUITE 301 CONCORD, NM 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $8K | $3K | $11K | 6.79% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $5K | $724 | $6K | 11.51% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC DBA CSONE | 2 DELTA DRIVE, SUITE 301 6TH FL CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $808 | $3K | 6.68% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $6K | $3K | $9K | 23.64% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES, LLC DBA CSONE | 2 DELTA DRIVE, SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $905 | $3K | 7.33% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.89% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN DBA HAYS COMPANIES | 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $1K | — | $1K | 3.14% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $478 | — | $478 | 5.00% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 SOUTH GARLAND AVENUE SUITE 203 ORLANDO, FL 32801 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $155 | $155 | 1.62% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 15.00% |
| COMBINED SERVICES LLC3 Filed as: COMBINED SERVICES LIMITED LIABILITY | 2 DELTA DRIVE SUITE 301 CONCORD, NH 03301 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $434 | — | $434 | 5.00% |
| PLANSOURCE BENEFITS ADMINISTRATION3 | 101 SOUTH GARLAND AVENUE SUITE 203 ORLANDO, FL 32801 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $144 | $144 | 1.66% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | ARAG INSURANCE COMPANY | $758 | — | $758 | 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 | 1,627 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,629 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM LIFE INSURANCE COMPANY | 1,627 | $15K |
| Dental | ALTUS DENTAL INSURANCE CO, INC. | 788 | $266K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 541 | $34K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 751 | $235K |
| Short-term disability(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 180 | $47K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 751 | $165K |
| Other(5 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 1,627 | $228K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,627 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.