| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $8K | $18K | 11.78% |
| KC MARKETING INC.4 | DBA LEGAL BENEFIT CONSULTANTS PO BOX 1833 SAINT CLOUD, MN 56302 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $761 | $0 | $761 | 6.97% |
| ALAN W. JUDD4 | 3532 LONG LAKE RD E SAINT PAUL, MN 55115 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $489 | $0 | $489 | 4.48% |
| DAVID J. KLEINSMITH4 | PO BOX 1833 SAINT CLOUD, MN 56302 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $296 | $0 | $296 | 2.71% |
| PATRICK LILLIS4 | PO BOX 1102 BELLEVUE, WA 68005 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $136 | $0 | $136 | 1.25% |
| DAVID M MISKOWIC4 Filed as: DAVID M. MISKOWIC | 3343 POLK ST. NE MINNEAPOLIS, MN 55418 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $116 | $0 | $116 | 1.06% |
| LORI A. LIENEMANN HARTKOPF4 | 317 CENTRAL AVENUE OSSEO, MN 55369 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $105 | $0 | $105 | 0.96% |
| LORI A. PAYNE4 | PO BOX 13 MAPLE HILL, KS 66507 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $21 | $0 | $21 | 0.19% |
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 | 309 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 309 | $150K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 309 | $150K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 309 | $150K |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 309 | $161K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 309 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.