| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $17K | — | $17K | 2.20% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | WYSSTA INSURANCE COMPANY INC | $9K | — | $9K | 7.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $767K |
| OPTUM RX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Claims processing; Other fees; Float revenue Service code 12 | — | $237K |
| SUN LIFE ASSURANCE COMPANY EIN 38-1082080 FMLA-ADMIN FEE | Claims processing Service code 12 | — | $126K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA=DENTAL | Contract Administrator Service code 13 | — | $76K |
| HAYS COMPANIES OF WI EIN 41-1932108 BROKER | Other commissions Service code 55 | — | $20K |
| HAYS COMPANIES EIN 41-1932108 BROKER | Other commissions Service code 55 | — | $835 |
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 | 2,760 | 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) | 2,760 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | WYSSTA INSURANCE COMPANY INC | 966 | $115K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,760 | $783K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,760 | $783K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,760 | $783K |
| Other(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,760 | $931K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,760 | — |
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.