| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | HUMANA HEALTH PLAN INC | $35K | $727 | $36K | 9.51% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP OF WI LLC | 1200 N MAYFAIR RD STE 100 BROOKFIELD, WI 53226 | HUMANA HEALTH PLAN INC | $18K | — | $18K | 4.81% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 530455800 | HUMANA DENTAL INSURANCE COMPANY | $3K | $808 | $3K | 1.42% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP OF WI LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | HUMANA DENTAL INSURANCE COMPANY | -$14 | — | -$14 | -0.01% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES | 100 N CORPORATE DR SUITE 100 BROOKFIELD, WI 53045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $376 | $3K | 4.15% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $766 | $2K | 2.60% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $427 | $4K | 5.60% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFIT GROUP OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $3K | 4.71% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SOLUTIONS | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 530545800 | HUMANA INSURANCE COMPANY | $944 | $204 | $1K | 2.91% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP OF WI LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | HUMANA INSURANCE COMPANY | -$22 | — | -$22 | -0.06% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $185 | $2K | 7.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $389 | $2K | 4.96% |
| DIVERSIFIED INSURANCE GROUP3 Filed as: DIVERSIFIED INSURANCE SERVICES INC | 100 N CORPORATE DR STE 100 BROOKFIELD, WI 53045 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $529 | $12K | 56.27% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $847 | $72 | $919 | 4.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| HUMANA HEALTH PLAN INC EIN 61-1013183 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $450K |
| EMPLOYEE BENEFITS CORPORATION EIN 39-2044064 ADMINISTRATOR | Contract Administrator Service code 13 | — | $7K |
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 | 574 | 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) | 574 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HUMANA DENTAL INSURANCE COMPANY | 368 | $244K |
| Vision | HUMANA INSURANCE COMPANY | 274 | $40K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 182 | $56K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 46 | $65K |
| Long-term disability(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 738 | $91K |
| Stop-loss / reinsurancereinsurance | HUMANA HEALTH PLAN INC | 226 | $376K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 738 | $125K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 738 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.