| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET #700 MINNEAPOLIS, MN 55402 | FALLON HEALTH | $8K | — | $8K | 1.96% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62937 PO BOX 62937 VIRGINIA BEACH, VA 23466 | FALLON HEALTH | $5K | — | $5K | 1.04% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET #700 MINNEAPOLIS, MN 55402 | FALLON HEALTH AND LIFE ASSURANCE COMPANY | $2K | — | $2K | 1.75% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 62937 NEW ENGLAND REGION VIRGINIA BEACH, VA 23466 | FALLON HEALTH AND LIFE ASSURANCE COMPANY | $2K | — | $2K | 1.25% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62937 SUITE 218 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $438 | $4K | 5.16% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1350 BAYSHORT HWY STE 218 BURLINGAME, CA 940101811 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $15 | $4K | 4.87% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET STE. 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $593 | $593 | 0.75% |
| USI INSURANCE SERVICES LLC3 | P.O. BOX 61007 VIRGINIA BEACH, VA 23466 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $393 | $393 | 0.50% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 133 FEDERAL STREET FL 2 BOSTON, MA 02110 | VISION SERVICE PLAN | $34 | — | $34 | 9.52% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | P.O. BOX 62937 VIRGINIA BEACH, VA 23466 | VISION SERVICE PLAN | -$6 | — | -$6 | -1.68% |
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 | 128 | 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) | 128 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | FALLON HEALTH | 58 | $561K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $79K |
| Vision | VISION SERVICE PLAN | 34 | $357 |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $79K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $79K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $79K |
| Prescription drug(2 contracts, 2 carriers) | FALLON HEALTH | 58 | $561K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 128 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 128 | — |
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.