| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 1200 NORTH MAYFAIR ROAD, SUITE 100 MILWAUKEE, WI 53226 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | $0 | $13K | 4.30% |
| PHILLIP PORTER GOODRUM3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $0 | $4K | 7.68% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $54 | $2K | 3.58% |
| IBENEFIT COMMUNICATION LLC3 Filed as: IBENEFIT COMMUNICATION, LLC | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $131 | $131 | 0.26% |
| THOMAS CHRISTOPHER SMITH3 | 798 BERRY ROAD NASHVILLE, TN 37204 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $21 | $0 | $21 | 0.04% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $7K | $3K | $10K | 29.42% |
| PHILLIP PORTER GOODRUM3 | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $791 | $0 | $791 | 2.30% |
| IBENEFIT COMMUNICATION LLC3 Filed as: IBENEFIT COMMUNICATION, LLC | 131 HILLSIDE AVENUE CHARLOTTE, NC 28209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $18 | $18 | 0.05% |
| THOMAS CHRISTOPHER SMITH3 | 798 BERRY ROAD NASHVILLE, TN 37204 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.03% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS AND INS SERVICES, INC | 2421 ATLANTIC AVENUE MANASQUAN, NJ 08736 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | $0 | $12 | 0.03% |
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 | 625 | 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) | 625 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 175 | $1.4M |
| Dental | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 175 | $1.4M |
| Vision | VISION SERVICE PLAN | 369 | $50K |
| Life insurance(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 625 | $337K |
| Short-term disability | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 81 | $34K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 625 | $303K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 175 | $1.4M |
| Other(3 contracts, 3 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 625 | $389K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 625 | — |
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.