| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP LLC | 80 SOUTH 8TH ST. STE 700 MINNEAPOLIS, MN 55402 | BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | $24K | $306 | $25K | 4.51% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP LLC | 80 SOUTH 8TH ST. STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $1K | $11K | 7.64% |
| DESIREE WENDELL3 | 40771 FENIAN WAY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $436 | $4K | 2.89% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $904 | $3K | 2.32% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $1K | $3K | 2.28% |
| JON OLSON3 | PO BOX 5423 MANKATO, MN 56002 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $407 | $2K | 1.36% |
| ANDREW CHARLES FELLS3 | 331 W HUMPHREY STREET LAKE CRYSTAL, MN 56055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $422 | $2K | 1.15% |
| NIKGREJESKEN INC3 Filed as: NIKGREJESKEN INC. | 120 SHELBY RD SHERWOOD, AR 72120 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $115 | $1K | 1.03% |
| TAMMY M DAHLBERG3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $87 | $1K | 0.92% |
| J&K DOUGLAS SALES INC3 | 150 CRYSTAL LAKE ROAD AUSTIN, AR 72007 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $85 | $1K | 0.82% |
| JACK ALAN HENNINGSGAARD3 | 2562 LOST LAKE RD MOUND, MN 55364 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $398 | $62 | $460 | 0.33% |
| BARNETT BENEFITS GROUP INC3 | 101 BARNETT RD LONOKE, AR 72086 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $444 | $14 | $458 | 0.33% |
| GINGER MULLINS & COMPANY INC3 | 1701 CENTERVIEW DR LITTLE ROCK, AR 72211 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $384 | $44 | $428 | 0.31% |
| ROBERT W ALLEN3 | 39 SUNCREST DR CABOT, AR 72023 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $253 | $5 | $258 | 0.19% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $123 | $0 | $123 | 0.09% |
| PATRICK M MCGOWAN3 | 4401 PARK GLEN RD MINNEAPOLIS, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | $0 | $100 | 0.07% |
| ANNA JANICE RUIZ3 Filed as: ANNA KRISTINA DUDECK | 1164 MERRIFIELD COURT SHAKOPEE, MN 55379 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $75 | $0 | $75 | 0.05% |
| ROBERTA ANNE OXFORD3 | 16920 KENMORE DRIVE LAKEVILLE, MN 55044 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $0 | $61 | 0.04% |
| DAVID EVANS3 | 2711 YORK CT SOUTHLAKE, TX 76092 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.02% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $7 | $20 | 0.01% |
| LAURA B WETT3 | 8496 100TH ST E NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $1 | $18 | 0.01% |
| EDWARD D SOMMER3 Filed as: EDWARD CHRIS ROSENLUND | 8672 MEADOWVALE DRIVE EDEN PRAIRIE, MN 55347 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.01% |
| SHIRLEY B DRAKE3 Filed as: SHIRLEY JOHNSON | 15719 FISH POINT ROAD SE PRIOR LAKE, MN 55372 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | $0 | $4 | 0.00% |
| JEFFREY LYLES3 | 3872 BALLANTRAE RD EAGAN, MN 55122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $0 | $3 | 0.00% |
| SUSAN G BOXRUD3 | 1804 MICHIGAN DRIVE NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $0 | $0 | $0 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP LLC | 80 SOUTH 8TH ST. STE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $2K | $13K | 9.68% |
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 | 210 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 210 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $130K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $130K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 206 | $138K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $130K |
| Stop-loss / reinsurancereinsurance | BCBSM, INC. DBA BLUE CROSS AND BLUE SHIELD OF MINNESOTA | 210 | $545K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 358 | $130K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 358 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.