| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WI LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 10.87% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF WI LLC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.71% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF WI EIN 39-0138065 ADMINISTRATIVE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Float revenue; Other services; Contract Administrator; Claims processing Service code 12 | — | $231K |
| EXPRESS SCRIPTS INC EIN 16-1279199 PRESCRIPTION DRUG REBATE | Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $0 |
| HAYS BENEFITS GROUP OF WI LLC BROKER | Insurance brokerage commissions and fees; Insurance agents and brokers; Other commissions Service code 22 | 1200 N MAYFAIR RD MILWAUKEE, WI 53226 | $0 |
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 | 281 | 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) | 281 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $121K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 466 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 466 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.