| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 554025345 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $13K | $13K | 2.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 554025345 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $1K | $1K | 1.76% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WIS. | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 4.13% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH ST SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | -$13 | -$13 | -0.04% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP OF WIS. | 1200 N MAYFAIR RD SUITE 100 MILWAUKEE, WI 53226 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 3.62% |
| C2 CENTRIC LLC3 | PO BOX 6824 GRAND RAPIDS, MI 49516 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | — | -$3 | -$3 | -0.01% |
| M3 INSURANCE SOLUTIONS INC3 | 828 JOHN NOLEN DRIVE MADISON, WI 53713 | PROVIDENT LIFE & ACCIDENT INSURANCE COMPANY | -$168 | — | -$168 | -0.60% |
No Schedule C service providers reported on this filing.
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 | 901 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 901 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 901 | $697K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 901 | $631K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 901 | $631K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 901 | $755K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 901 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.