| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | $2K | $16K | 17.03% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $11K | 16.99% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF WISCONSIN | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $6K | — | $6K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $270K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA-DENTAL | Contract Administrator Service code 13 | — | $23K |
| HAYS COMPANIES BROKER | Other commissions; Insurance agents and brokers Service code 22 | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | $20K |
| UNUM LIFE INSURANCE COMPANY OF AMER EIN 01-0278678 ADMINSTRATOR | Claims processing Service code 12 | — | $16K |
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 | 1,068 | 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) | 1,068 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 438 | $61K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,068 | $155K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,068 | $92K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,068 | $92K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,068 | — |
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.