| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | DELTA DENTAL OF WISCONSIN | $1K | — | $1K | 1.17% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | RELIASTAR LIFE INSURANCE COMPANY | $16K | — | $16K | 16.91% |
| UKG INC3 | PO BOX 930953 ATLANTA, GA 31193 | RELIASTAR LIFE INSURANCE COMPANY | $750 | — | $750 | 0.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Other fees; Claims processing; Float revenue Service code 12 | — | $346K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $98K |
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 | 191 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF WISCONSIN | 145 | $107K |
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 116 | $11K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 194 | $92K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 194 | $92K |
| Stop-loss / reinsurancereinsurance | SUNLIFE ASSURANCE COMPANY | 127 | $519K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 194 | $112K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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."
No prospect flags tripped on this filing.