| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH ST., STE 700 MINNEAPOLIS, MN 55402 | ULLICO | $5K | — | $5K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF MN EIN 41-0984460 NONE | Claims processing; Contract Administrator Service code 12 | — | $1.9M |
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Contract Administrator; Accounting (including auditing); Claims processing Service code 10 | — | $817K |
| MCGRANN SHEA CARNIVAL STRAUGHN EIN 41-1654544 NONE | Legal Service code 29 | — | $348K |
| THE MCKEOGH COMPANY EIN 23-3003375 NONE | Actuarial Service code 11 | — | $57K |
| DELTA DENTAL EIN 41-1905554 NONE | Contract Administrator; Claims processing Service code 12 | — | $47K |
| PRIME THERAPEUTICS EIN 26-0076803 NONE | Claims processing; Other services; Float revenue Service code 12 | — | $29K |
| MAIRS AND POWER, INC. EIN 41-0844499 NONE | Soft dollars commissions; Investment management; Investment management fees paid directly by plan Service code 28 | — | $26K |
| T.E.A.M., INC. EIN 83-0469948 NONE | Other services Service code 49 | — | $26K |
| UNION BANK & TRUST EIN 41-1267434 NONE | Account maintenance fees; Custodial (securities) Service code 19 | — | $23K |
| NUVEEN ASSET MANAGEMENT, LLC EIN 27-4357327 NONE | Investment management fees paid directly by plan; Investment management Service code 28 | — | $21K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $18K |
| STANDARD VALUATIONS, INC. EIN 41-1327339 NONE | Investment advisory (plan) Service code 27 | — | $13K |
| HONSA-BINDER PRINTING, INC NONE | Other services Service code 49 | 320 SPRUCE STREET ST PAUL, MN 55101 | $8K |
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 | 2,270 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 187 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,457 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MN | 168 | $376K |
| Life insurance | ULLICO | 1,614 | $53K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MN | 169 | $162K |
| Stop-loss / reinsurancereinsurance | BLUE CROSS BLUE SHIELD OF MN | 1,561 | $436K |
| Other | ULLICO | 1,614 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,614 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.