| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE INDEMNITY GROUP LLC3 Filed as: INDEMNITY GROUP LLC | 3628 WALNUT HILLS AVE STE 200 ORANGE VILLAGE, OH 441224484 | MEDICAL MUTUAL | — | $18K | $18K | 2.03% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP OF WI LLC | 1200 NORTH MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $8K | $8K | 2.05% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP WISCONSIN | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 2.62% |
| CUSTOM BENEFIT PROGRAMS INC3 | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $610 | $493 | $1K | 1.15% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $485 | — | $485 | 0.50% |
| HAYS COMPANIES, INC.3 Filed as: JAMES C HAYS | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $91 | — | $91 | 0.09% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $42 | $42 | 0.04% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF WISCONSIN | PO BOX 1414 MINNEAPOLIS, MN 55480 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.16% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $570 | $570 | 2.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF WISCONSIN | PO BOX 1414 MINNEAPOLIS, MN 55480 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 14.10% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $291 | $291 | 2.00% |
| BARRET BENEFITS GROUP INC.3 Filed as: BARRET BENEFITS GROUP INC | 3628 WALNUT HILLS AVE SUITE 200 BEACHWOOD, OH 441224484 | VISION SERVICE PLAN | $538 | — | $538 | 9.33% |
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 | 1,311 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,319 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICAL MUTUAL | 133 | $874K |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 366 | $114K |
| Vision(2 contracts, 2 carriers) | NATIONAL VISION ADMINISTRATORS LLC | 543 | $48K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,319 | $509K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,319 | $509K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,319 | $427K |
| Prescription drug | MEDICAL MUTUAL | 133 | $874K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,319 | $441K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,319 | — |
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.