| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 NMAYFAIR ROAD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $338 | $338 | 0.64% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $108 | $108 | 0.63% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $46 | $46 | 0.69% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Float revenue; Other fees; Claims processing; Direct payment from the plan Service code 12 | — | $404K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $150K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA | Contract Administrator Service code 13 | — | $14K |
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 | 408 | 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) | 408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 253 | $21K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 408 | $53K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 135 | $17K |
| Other(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 408 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.