| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | HEALTHPARTNERS INSURANCE COMPANY | $41K | $12K | $53K | 3.18% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8K | $2K | $10K | 2.31% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $3K | $7K | 1.67% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $2K | $4K | 0.88% |
| ZACKARY JAMES HALLER3 Filed as: ZACKARY HALLER | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $111 | $2K | 0.36% |
| MELONY LEE MICHAELS3 Filed as: MELONY MICHEALS | 4200 WEDGEWOOD LANE N PLYMOUTH, MI 55442 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $76 | $2K | 0.35% |
| ROSE MARY GOODMAN3 | 5200 HOLLY LN. N. #4 PLYMOUTH, MN 55446 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $48 | $2K | 0.35% |
| JON OLSON3 | 5650 W. 36TH ST. APT. 509 ST. LOUIS PARK, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $171 | $1K | 0.29% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN LUCAS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $593 | $397 | $990 | 0.22% |
| ELIZABETH MARIE LANGEVIN3 Filed as: ELIZABETH LANGEVIN | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $501 | $224 | $725 | 0.16% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $339 | $175 | $514 | 0.12% |
| CURTIS LARSON3 | 11626 YUKON ST. NW COON RAPIDS, MN 55433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $242 | $19 | $261 | 0.06% |
| CARRIE S FLATEN3 Filed as: CARRIE FLATEN | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $184 | $50 | $234 | 0.05% |
| ROBERT SCOTT BRUNER3 Filed as: ROBERT BRUNER | 987 LACY CT BELLE PLAINE, MN 56011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $98 | $135 | $233 | 0.05% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 3357 POLK ST. NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | $15 | $92 | 0.02% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 6.87% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP, LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $4K | $2K | $5K | 11.36% |
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 | 165 | 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) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTHPARTNERS INSURANCE COMPANY | 296 | $2.1M |
| Dental | HEALTHPARTNERS INSURANCE COMPANY | 296 | $1.7M |
| Life insurance | STANDARD INSURANCE COMPANY | 165 | $45K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $75K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 166 | $75K |
| Prescription drug | HEALTHPARTNERS INSURANCE COMPANY | 296 | $1.7M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 296 | — |
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."
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.