| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $59K | $29K | $88K | 19.66% |
| USI INSURANCE SERVICES LLC3 | 8000 NORMAN CENTER DRIVE #400 BLOOMINGTON, MN 55437 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 3.28% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MA 55374 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $41 | $3K | 2.33% |
| JACQUELINE BARTHELEMY3 | 7573 HILTON ROAD ROYALTON, MN 56373 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $8 | $2K | 1.27% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $656 | $5 | $661 | 0.47% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $522 | $4 | $526 | 0.37% |
| JON OLSON3 | 360 CARLSON PARKWAY UNIT 203 MINNETONKA, MN 55305 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $361 | $0 | $361 | 0.25% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PARKWAY ATLANTA, GA 30339 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $309 | $0 | $309 | 0.22% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET MINNEAPOLIS, MA 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $289 | $12 | $301 | 0.21% |
| LINDA R MARCUM3 | 1147 N. BROAD ST LEXINGTON, TN 38351 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $295 | $0 | $295 | 0.21% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $270 | $2 | $272 | 0.19% |
| BILLY MARK ROBERSON3 | 17415 SHADY CANYON SAN ANTONIO, TX 78248 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $267 | $0 | $267 | 0.19% |
| ASHLEY MARIA HOUTMAN3 | 3108 WESTEDGE BLVD MOUND, MN 55364 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $246 | $0 | $246 | 0.17% |
| MELISSA ARMATIS3 Filed as: MELISSA JEAN WOKASCH | 900 NORTH SHORE DR DETROIT LAKES, MN 56501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $239 | $0 | $239 | 0.17% |
| WENDY DAWN PACK3 Filed as: WENDY ELIZABETH BROWNING | 7127 AVIGNON DR ROUND ROCK, TX 78681 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $224 | $0 | $224 | 0.16% |
| KINDA JACKSON3 | 1811 BROOKSIE THOMPSON RD DECATURVILLE, TN 38329 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $220 | $0 | $220 | 0.16% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 1009 8TH AVE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $136 | $15 | $151 | 0.11% |
| JEFFREY MICHAEL OURADNIK3 | PO BOX 578 NISSWA, MN 56468 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $0 | $84 | 0.06% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $84 | $0 | $84 | 0.06% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $52 | $0 | $52 | 0.04% |
| ZACKARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $50 | $0 | $50 | 0.04% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $36 | $0 | $36 | 0.03% |
| DESIREE WENDELL3 | 38269 EVERTON AVE NORTH BRANCH, MN 55056 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.02% |
| CAROLYN GROVER3 | 206 FOX CHAPEL DR IRMO, SC 29063 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $15 | $0 | $15 | 0.01% |
| SABRINA S RAMOS3 | 13750 W. COLONIAL DR WINTER GARDENS, FL 34787 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8 | $0 | $8 | 0.01% |
| MICHAEL A DUARTE3 | 515 DULL STREET DICKSON, TN 37055 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $7 | $0 | $7 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | EYEMED VISION CARE | $11K | $0 | $11K | 19.46% |
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 | 563 | 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) | 563 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE | 864 | $59K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 760 | $446K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 760 | $446K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 760 | $446K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 760 | $588K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 864 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.