| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 SOUTH 8TH ST#700 MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | $5K | $20K | 6.49% |
| AEGIS INTERNATIONAL INSURANCE3 Filed as: AEGIS INTERNATIONAL INS. CORP. | VILLA CAPARRA #243 STATE RD. #2 GUAYNABO, PR 009661915 | HUMANA INSURANCE OF PUERTO RICO, INC. | $5K | $0 | $5K | 5.29% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC | 80SO. 8TH ST., STE 700 MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| AEGIS INTERNATIONAL INSURANCE3 Filed as: AEGIS INTERNATIONAL INS. CORP | VILLA CAPARRA #243 STATE RD. #2 GUAYNABO, PR 009661915 | MCS LIFE INSURANCE CO. | $836 | — | $836 | 6.31% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP,INC. | 80TH SO. 8TH ST., STE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $0 | $52 | $52 | — |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP,INC. | 80TH SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $0 | $0 | $0 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MANAGER | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $483K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 2100 RIVEREDGE PARKWAY SANDY SPRINGS, GA 30328 | $197K |
| THE HAYS GROUP, INC. EIN 41-1784898 BROKER | Other commissions Service code 55 | 80 S. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | $17K |
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 | 377 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 382 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HUMANA INSURANCE OF PUERTO RICO, INC. | 23 | $126K |
| Vision | VISION SERVICE PLAN | 264 | $26K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 377 | $308K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 377 | $308K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 377 | $308K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 377 | $308K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 377 | — |
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.