| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 S MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | — | $7K | 7.98% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 S MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 11.50% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 S MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 11.48% |
| 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% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 12.78% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 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 | $3K | — | $3K | 13.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Direct payment from the plan; Other fees; Float revenue Service code 12 | — | $351K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $102K |
| DELTA DENTAL EIN 39-6094742 TPA-DENTAL | Contract Administrator Service code 13 | — | $17K |
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 | 449 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 460 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUPERIOR VISION INSURANCE PLAN OF WISCONSIN INC | 277 | $41K |
| Life insurance(4 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 416 | $134K |
| Short-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 283 | $113K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 228 | $68K |
| Other(4 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 662 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 662 | — |
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.