| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP INC | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNITEDHEALTHCARE INSURANCE COMPANY | $70K | — | $70K | 4.13% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 18201 VON KARMAN AVE STE 1020 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $372 | — | $372 | 9.99% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 18201 VON KARMAN AVE STE 1020 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $254 | — | $254 | 9.98% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 18201 VON KARMAN AVE STE 1020 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $90 | — | $90 | 9.97% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 18201 VON KARMAN AVE STE 1020 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $73 | — | $73 | 9.96% |
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 | 207 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 429 | $1.7M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 429 | $1.7M |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 429 | $1.7M |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $3K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 19 | $903 |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $4K |
| Prescription drug | UNITEDHEALTHCARE INSURANCE COMPANY | 429 | $1.7M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 210 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 429 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.