| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | IDS CENTER 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 0.80% |
| UMR, INC.3 Filed as: UMR | 5151 PFEIFFER ROAD ML 400 PFEIFFER WOODS CINCINNATI, OH 45242 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 0.12% |
| AXA ASSISTANCE, USA3 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $259 | $259 | 0.08% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 2.63% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 122 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | DELTA DENTAL OF WISCONSIN | $2K | — | $2K | 1.68% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 2.52% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 2.55% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $427 | $427 | 2.43% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 NORTH MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $174 | $174 | 2.52% |
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 | 2,064 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 10 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,085 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 578 | $147K |
| Life insurance(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,185 | $448K |
| Short-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,185 | $570K |
| Long-term disability(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,185 | $450K |
| Stop-loss / reinsurancereinsurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 1,400 | $1.0M |
| Other(4 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 2,185 | $472K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,185 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.