| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $18K | $0 | $18K | 10.31% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $1K | $0 | $1K | 3.76% |
| CATHY J OLIVER3 | 14795 BOISE CIR ROSEMOUNT, MN 55068 | AFLAC | $2K | $79 | $2K | 5.38% |
| JEFFREY A PETERSON3 | 1812 LAUREL AVE SAINT PAUL, MN 55104 | AFLAC | $697 | $0 | $697 | 2.05% |
| JOSEPH GAUTHIER3 Filed as: JOSEPH G GAUTHIER | 1815 14TH ST NW ROCHESTER, MN 55901 | AFLAC | $212 | $0 | $212 | 0.62% |
| LUCAS BAUMGARTNER3 | 667 158TH AVE NW ANDOVER, MN 55304 | AFLAC | $147 | $19 | $166 | 0.49% |
| MICHAEL ROBERT YURCZYK3 Filed as: MICHAEL ROBERT YURCYZK | 9616 WYOMING TER S BLOOMINGTON, MN 55438 | AFLAC | $137 | $0 | $137 | 0.40% |
| TONYA LYNNE WYNES3 | 6017 SCENIC LAKE DR GEORGETOWN, TX 78626 | AFLAC | $98 | $0 | $98 | 0.29% |
| COURTNEY RYAN YURCZYK3 Filed as: COURTNEY RYAN YRUCZYK | 9616 WYOMING TER S MINNEAPOLIS, MN 55438 | AFLAC | $95 | $0 | $95 | 0.28% |
| SHELLY LUCKEN3 | 8233 W 133RD PL SAVAGE, MN 55378 | AFLAC | $85 | $0 | $85 | 0.25% |
| MELISSA A MURRAY3 | 327 LIONHEART DR HICKSON, ND 58047 | AFLAC | $85 | $0 | $85 | 0.25% |
| MEGAN M MRAZ3 | 105 NORTH ST LEWISTON, MN 55952 | AFLAC | $64 | $19 | $83 | 0.24% |
| DARIN D PAVLISH3 | 8312 152ND PL SAVAGE, MN 55378 | AFLAC | $57 | $0 | $57 | 0.17% |
| JOELLE M BUELL3 | 820 5TH AVE SE WASECA, MN 56093 | AFLAC | $56 | $0 | $56 | 0.17% |
| NICOLE D BLAKE3 | 1226 CULVER AVE NW BUFFALO, MN 55313 | AFLAC | $55 | $0 | $55 | 0.16% |
| MIKE HORRAS3 | 1640 84TH CT N BROOKLYN PARK, MN 55444 | AFLAC | $49 | $0 | $49 | 0.14% |
| JOHN PAUL THOMPSON SR3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $42 | $0 | $42 | 0.12% |
| MISTY LYNNE CASTON3 | 3243 MCKINLEY ST NE MINNEAPOLIS, MN 55418 | AFLAC | $32 | $0 | $32 | 0.09% |
| BARRY CAMPBELL3 | 2798 COUNTY ROAD 80 ALGER, OH 45812 | AFLAC | $27 | $0 | $27 | 0.08% |
| THERESA WILLIAMS JONES3 | 125 CLIFFVIEW DR QUITMAN, AR 72121 | AFLAC | $26 | $0 | $26 | 0.08% |
| BRIAN KUYATT3 | 17590 ITALY PATH LAKEVILLE, MN 55044 | AFLAC | $20 | $0 | $20 | 0.06% |
| MICHELLE RAE MAGUIRE3 | 7825 WASHINGTON AVE S SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $15 | $0 | $15 | 0.04% |
| WILLIAM JOSEPH MCEVOY3 | 914 8TH AVE S SOUTH SAINT PAUL, MN 55075 | AFLAC | $13 | $0 | $13 | 0.04% |
| LYNN B KEEFER3 | 1743 MEADOWLARK RD EAGAN, MN 55122 | AFLAC | $11 | $0 | $11 | 0.03% |
| GREGORY F STENZEL3 | 14054 BADIANDS DR FRISCO, TX 75035 | AFLAC | $7 | $0 | $7 | 0.02% |
| BRICE L CAMPBELL3 | 360 LIBERTY HEIGHTS DR CHASKA, MN 55318 | AFLAC | $4 | $0 | $4 | 0.01% |
| JEREMY L TOMLINSON3 | 6305 W RUSSETT ST BOISE, ID 83704 | AFLAC | $3 | $0 | $3 | 0.01% |
| JEFFREY M HANSEN3 | 1895 52ND ST SW PEQUOT LAKES, MN 56472 | AFLAC | $2 | $0 | $2 | 0.01% |
| LEESA J CHURCHILL3 Filed as: LEESA JO CHURCHILL | 13929 WOODRIDGE PATH SAVAGE, MN 55378 | AFLAC | $1 | $0 | $1 | 0.00% |
| KNUTE NELSON3 | 920 AUTUMN SAGE WAY PFLUGERVILLE, TX 78660 | AFLAC | $1 | $0 | $1 | 0.00% |
| JENNIFER SMITH3 Filed as: JENNIFER L SMITH | 4640 S STEWART AVE SPRINGFIELD, MO 65804 | AFLAC | $1 | $0 | $1 | 0.00% |
| PATRICIA M JESPERSON3 | 2311 UPTON AVE N MINNEAPOLIS, MN 55411 | AFLAC | $1 | $0 | $1 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $2K | $0 | $2K | 13.63% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH STREET #700 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $454 | $0 | $454 | 3.87% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 80 SOUTH 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | $365 | $0 | $365 | 3.11% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $382 | $0 | $382 | 7.69% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $23 | $0 | $23 | 0.60% |
| STEVE BAKER3 | 153 ESTHER DR COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $350 | $0 | $350 | 14.06% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $45 | $0 | $45 | 4.06% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $6 | $0 | $6 | — |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $110 | $0 | $110 | — |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $21 | $0 | $21 | — |
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 | 219 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO | 231 | $12K |
| Life insurance(6 contracts) | STANDARD INSURANCE COMPANY | 219 | $57K |
| Short-term disability | AFLAC | 31 | $34K |
| Long-term disability | STANDARD INSURANCE COMPANY | 217 | $176K |
| Other(4 contracts, 3 carriers) | AFLAC | 219 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.