| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | — | $16K | 12.96% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $10K | — | $10K | 9.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 13.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF WISCONSIN | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | $2K | — | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Other fees; Direct payment from the plan; Float revenue Service code 12 | — | $317K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $133K |
| DELTA DENTAL EIN 39-6094742 TPA-DENTAL | Contract Administrator Service code 13 | — | $19K |
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 | 394 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 408 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 267 | $49K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 386 | $142K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 274 | $115K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 213 | $69K |
| Other(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 657 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 657 | — |
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.