| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP INC | 80 S EIGHTH ST STE 700 MINNEAPOLIS, MN 55402 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $1K | $1K | 0.07% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP OF WI | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $35K | — | $35K | 14.22% |
| GOODRUM, PHILLIP, PORTER3 | 131 HILLSIDE AVE CHARLOTTE, NC 28209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $28K | $4K | $32K | 34.25% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP OF WISCONSIN | 80 S 8TH ST STE 700 MINNEAPLOIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $12K | $957 | $13K | 14.49% |
| SMITH, THOMAS, CHRISTOPHER3 Filed as: SMITH, THOMAS, CHRISTOPER | PO BOX 6650 METAIRIE, LA 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 1.50% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: REUBEN WARNER ASSOCIATES INC | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | — | $1K | $1K | 19.99% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 1200 N MAYFAIR RD STE 100 MILWAUKEE, WI 53226 | BERKLEY LIFE AND HEALTH INSURANCE COMPANY | $751 | — | $751 | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $390K |
| ELIXIR EIN 90-1011712 PHARMACY BENEFIT MGMT | Claims processing; Other fees; Float revenue; Direct payment from the plan Service code 12 | — | $49K |
| HAYS COMPANIES OF WI EIN 41-1932108 BROKER | Insurance agents and brokers; Other commissions Service code 22 | — | $31K |
| DELTA DENTAL OF WISCONSIN EIN 39-6094742 TPA-DENTAL | Contract Administrator Service code 13 | — | $29K |
| COMPSYCH EIN 22-1211670 TPA | Contract Administrator Service code 13 | — | $13K |
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 | 763 | 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) | 763 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 576 | $82K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 653 | $246K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 653 | $246K |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 763 | $344K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 763 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.