| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAY COMPANIES, INC. | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNITED HEALTHCARE INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.98% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, WI 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 5.24% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $13K | — | $13K | 16.68% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 10.28% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE STE 100 MOUNT PLEASANT, WI 53406 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 17.39% |
| JOHNSON INSURANCE SERVICES LLC3 | 1103 HUNTER DRIVE STE 100 MOUNT PLEASANT, WI 53406 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $333 | — | $333 | 3.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 5901 LINCOLN DRIVE MINNEAPOLIS, MN 55436 | $298K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 2801 HOOVER ROAD PO BOX 828 STEVENS POINT, WI 54881 | $22K |
| HAYS COMPANIES, INC. INSURANCE BROKER | Insurance agents and brokers Service code 22 | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | $587 |
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 | 504 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 509 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 310 | $69K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 503 | $133K |
| Short-term disability(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 351 | $152K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 501 | $144K |
| Stop-loss / reinsurancereinsurance | UNITED HEALTHCARE INSURANCE COMPANY | 1,048 | $896K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,048 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.