| 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 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $257 | $9K | 10.29% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $1K | $5K | 12.85% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH STREET 700 MINNEAPOLIS, MN 554022105 | VISION SERVICE PLAN | $1K | — | $1K | 4.89% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF MINNESOTA INC | 1600 UTICA AVE S MINNEAPOLIS, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.84% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $609 | $85 | $694 | 2.69% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $560 | $32 | $592 | 2.30% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $257 | $38 | $295 | 1.14% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $230 | $7 | $237 | 0.92% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $148 | — | $148 | 0.57% |
| SAMANTHA L GRIMSLEY3 Filed as: SAMANTHA L GRIMSELY | 111 RAMBLING CREEK DRIVE ST MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.46% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $83 | $6 | $89 | 0.35% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | $13 | $64 | 0.25% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.07% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $911 | $27 | $938 | 10.29% |
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 | 639 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 641 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 51 | $26K |
| Vision | VISION SERVICE PLAN | 202 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 609 | $90K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 51 | $26K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 609 | $40K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 609 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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.