| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | ANTHEM BLUE CROSS AND BLUE SHIELD | $71K | — | $71K | 4.94% |
| AMWINS3 Filed as: LISI INC | 1600 WEST HILLSDALE BLVD SAN MATEO, CA 94402 | ANTHEM BLUE CROSS AND BLUE SHIELD | — | $28K | $28K | 1.97% |
| STELLA CHANG3 | 3480 ORIOLE PLACE FREMONT, CA 94555 | ANTHEM BLUE CROSS AND BLUE SHIELD | -$66 | — | -$66 | -0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 64105 | DELTA DENTAL | $14K | — | $14K | 10.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S. 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | VSP | $3K | — | $3K | 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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL | 132 | $140K |
| Vision | VSP | 126 | $26K |
| Prescription drug | ANTHEM BLUE CROSS AND BLUE SHIELD | 110 | $1.4M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.