| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | SYMETRA LIFE INSURANCE COMPANY | — | $44K | $44K | 3.34% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $82K | — | $82K | 15.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $6K | — | $6K | 1.16% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | UNITEDHEALTHCARE INSURANCE COMPANY | $28K | — | $28K | 9.12% |
| AMWINS3 | 50 WHITECAP DR. NORTH KINGSTOWN, RI 02852 | STERLING LIFE MED D RX | $16K | — | $16K | 5.48% |
| AMWINS3 | 50 WHITECAP DR. NORTH KINGSTON, RI 02852 | TRANSAMERICA INSURANCE COMPANY | $29K | — | $29K | 13.64% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | — | $9K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CYPRESS BENEFIT ADMINISTRATORS EIN 39-1997579 NONE | Claims processing Service code 12 | — | $938K |
| AMERICAN HEALTH HOLDINGS. EIN 31-1368946 NONE | Other fees Service code 99 | — | $290K |
| PARTNERS RX MANAGEMENT, LLC EIN 86-1042036 NONE | Direct payment from the plan; Claims processing; Other fees Service code 12 | — | $274K |
| HEALTH PAYMENT SYSTEMS EIN 20-2702059 NONE | Claims processing Service code 12 | — | $166K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 NONE | Claims processing Service code 12 | — | $118K |
| CONSULT A DOC EIN 31-1368946 NONE | Other fees Service code 99 | — | $95K |
| TRILOGY HEALTH INSURANCE EIN 20-5598514 NONE | Other fees Service code 99 | — | $75K |
| ALITHIAS NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other fees Service code 15 | 1101 N. MARKET ST., STE. 2M MILWAUKEE, WI 53202 | $63K |
| CONCERT HEALTH RESOURCES NONE | Contract Administrator; Direct payment from the plan; Other fees Service code 13 | PO BOX 403 KAUKAUNA, WI 54130 | $43K |
| HEALTHEOS BY MULTIPLAN, INC. EIN 39-1634080 NONE | Other fees Service code 99 | — | $41K |
| PREMIERE HEALTHCARE EXCHANGE EIN 86-1040704 NONE | Other fees Service code 99 | — | $27K |
| SOUTH CENTRAL PREFERRED EIN 23-2664989 NONE | Other fees Service code 99 | — | $25K |
| PREFERREDONE EIN 41-1846481 NONE | Other fees Service code 99 | — | $22K |
| OHIO HEALTH PLAN EIN 34-1895396 NONE | Other fees Service code 99 | — | $10K |
| PNC INSTITUTIONAL, INC. NONE | Other fees Service code 99 | 249 5TH AVE., STE. 30 PITTSBURGH, PA 15222 | $7K |
| COFINITY EIN 20-1274723 NONE | Other fees Service code 99 | — | $6K |
| THE HAYS GROUP OF WISCONSIN, LLC | Insurance agents and brokers Service code 22 | — | $1K |
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 | 4,196 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 647 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 4,843 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | TRANSAMERICA INSURANCE COMPANY | 125 | $216K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 4,895 | $304K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 4,840 | $1.1M |
| Prescription drug | STERLING LIFE MED D RX | 125 | $287K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | SYMETRA LIFE INSURANCE COMPANY | 3,482 | $1.3M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 5,694 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,694 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.