| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 S. 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | — | $0 | 0.00% |
| HAYS COMPANIES, INC.3 | 80 S. 8TH ST. SUITE 700 MINNEAPOLIS, WI 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.15% |
| HAYS COMPANIES, INC.3 | 80 S. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.92% |
| HAYS COMPANIES, INC.3 | 80 S. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | — | $12K | 17.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF WISCONSIN | 1200 N. MAYFAIR ROAD MILWAUKEE, WI 53226 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $4K | — | $4K | 5.82% |
| HAYS COMPANIES, INC.3 | 80 S. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 11.97% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE COMPANY OF AMERICA | $617 | — | $617 | 4.34% |
| RSC INSURANCE BROKERAGE INC3 Filed as: RSC INSURANCE BROKERAGE, INC. | 1103 HUNTER DR SUITE 100 MOUNT PLEASANT, WI 53406 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 2.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Claims processing; Other services Service code 12 | 5901 LINCOLN DR. MINNEAPOLIS, MN 55436 | $286K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 THIRD PARTY ADMINISTRATOR | Contract Administrator Service code 13 | 2801 HOOVER RD. PO BOX 828 STEVENS POINT, WI 54881 | $23K |
| HAYS COMPANIES EIN 41-1949344 BROKER | Insurance agents and brokers; Other commissions Service code 22 | 1200 N. MAYFAIR ROAD SUITE 100 MILWAUKEE, WI 53226 | $939 |
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 | 448 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 20 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 468 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 309 | $69K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 457 | $127K |
| Short-term disability(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 300 | $162K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 457 | $168K |
| Stop-loss / reinsurancereinsurance | UNITEDHEALTHCARE INSURANCE COMPANY | 943 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 943 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.