| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $26K | $815 | $27K | 15.47% |
| DAVID J. KLEINSMITH4 | PO BOX 1833 SAINT CLOUD, MN 56302 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | $0 | $1K | 22.11% |
| KCA MARKETING INC DBA LEGAL BENEFIT4 Filed as: KCA MARKETING INC. | DBA LEGAL BENEFIT CONSULTANTS PO BOX 1833 SAINT CLOUD, MN 56302 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $146 | $0 | $146 | 2.42% |
| ALAN W. JUDD4 | 3532 LONG LAKE RD E SAINT PAUL, MN 55115 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $58 | $0 | $58 | 0.96% |
| DIANNE M. CHURIK4 Filed as: DIANNE CHURIK | 10940 CROOKED LANE BLVD N APT 424 MINNEAPOLIS, MN 55433 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $58 | $0 | $58 | 0.96% |
| MARC A HANSON4 | 1006 7TH AVE SE BARNESVILLE, MN 56514 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $50 | $0 | $50 | 0.83% |
| DERYK B PETERSEN4 | 808 LE COVE CT VIRGINIA BEACH, VA 23464 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $22 | $0 | $22 | 0.36% |
| PATRICK LILLIS4 | PO BOX 1102 BELLEVUE, NE 68005 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $12 | $0 | $12 | 0.20% |
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 | 300 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 308 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 254 | $9K |
| Life insurance | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 308 | $174K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 308 | $174K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 308 | $174K |
| Other(2 contracts, 2 carriers) | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 308 | $180K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 308 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
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.