| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 6711 COLUMBIA GATEWAY DR SUITE 450 COLUMBIA, MD 21046 | SYMETRA LIFE INSURANCE COMPANY | $27K | — | $27K | 5.43% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | — | $6K | 5.16% |
| UNITED OF OMAHA LIFE INSURANCE CO5 Filed as: UNITED OF OMAHA LIFE INSURANCE CO. | MUTUAL OF OMAHA PLAZA OMAHA, NE 68175 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 5.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 2.87% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.65% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 1.48% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 1.14% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 0.93% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $215 | $215 | 0.18% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNIFIED LIFE INSURANCE COMPANY | — | $200 | $200 | 0.51% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF WISCONSIN | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | WYSSTA INSURANCE COMPANY INC | $2K | — | $2K | 8.04% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441220 PHARMACY BENEFIT MANAGEME | Float revenue; Claims processing; Direct payment from the plan; Other fees Service code 12 | — | $690K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | 2700 MIDWEST DRIVE ONALASKA, WI 546508763 | $131K |
| HAYS COMPANIES EIN 41-1932108 BROKER | Other commissions Service code 55 | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | $54K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 100 N. CORPORATE DR. STE 100 BROOKFIELD, WI 53045 | $12K |
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 | 280 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 284 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 132 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $117K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $117K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 280 | $117K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 207 | $499K |
| Other | UNIFIED LIFE INSURANCE COMPANY | 4 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 280 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.