| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | BLUECROSS BLUESHIELD OF ILLINOIS | $8K | $6K | $15K | 3.38% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.93% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 2.02% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF ILLINOIS | 1 S. WACKER DRIVE, SUITE 3350 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | — | $8K | 10.60% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $3K | $3K | 3.93% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $2K | $2K | 2.79% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF ILLINOIS | 1 S. WACKER DRIVE, SUITE 3350 CHICAGO, IL 60606 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $954 | — | $954 | 17.40% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $322 | $322 | 5.87% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $180 | — | $180 | 6.97% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $104 | $104 | 4.03% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | — | $76 | $76 | 2.94% |
| LOCKTON COMPANIES, LLC3 | 500 WEST MONROE STREET, SUITE 3400 CHICAGO, IL 60661 | FIRST UNUM LIFE INSURANCE COMPANY | — | $22 | $22 | 2.11% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUECROSS BLUESHIELD OF ILLINOIS EIN 36-1236610 MEDICAL ADMINISTRATOR | Claims processing Service code 12 | — | $323K |
| GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 DENTAL ADMINISTRATOR | Contract Administrator Service code 13 | — | $28K |
| UNUM LIFE INSURANCE COMPANY OF AM. EIN 01-0278678 STD ADMINISTRATOR | Claims processing Service code 12 | — | $16K |
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 | 603 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 638 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 429 | $46K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 603 | $176K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 49 | $1K |
| Long-term disability(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 603 | $180K |
| Stop-loss / reinsurancereinsurance | BLUECROSS BLUESHIELD OF ILLINOIS | 1,317 | $432K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 603 | $176K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,317 | — |
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.