| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $509 | $509 | 2.51% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER TECHNOLOGIES | 2734 NORTH MILDRED AVE CHICAGO, IL 60614 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $304 | $304 | 1.50% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $364 | $364 | 1.99% |
| WATCHTOWER BENEFITS, LLC3 Filed as: WATCHTOWER TECHNOLOGIES | 2734 NORTH MILDRED AVE CHICAGO, IL 60614 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $275 | $275 | 1.50% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | WYSSTA INSURANCE COMPANY INC | $1K | — | $1K | 7.39% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CVS PHARMACY INC EIN 05-0340626 ADMIN | Claims processing Service code 12 | — | $171K |
| UHC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | — | $79K |
| DELTA DENTAL EIN 39-6094742 TPA-DENTAL | Contract Administrator Service code 13 | — | $6K |
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 | 132 | 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) | 132 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 109 | $14K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 128 | $20K |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 132 | $18K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 128 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 132 | — |
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."
No prospect flags tripped on this filing.