| 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 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | $5K | $20K | 20.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $2K | $8K | 20.54% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $2K | $434 | $3K | 7.32% |
| NATIONAL ENROLLMENT PARTNERS LLC3 | 201 CAUGHMAN FARM LANE LEXINGTON, SC 29072 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $137 | $2K | $2K | 5.08% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $952 | $294 | $1K | 3.51% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $468 | $331 | $799 | 2.25% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6505 DEMPSEY AVE SW WAVERLY, MN 55390 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $485 | $133 | $618 | 1.74% |
| ZACKARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $393 | $10 | $403 | 1.14% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $269 | $66 | $335 | 0.94% |
| ELIZABETH MARIE LANGEVIN3 | 698 LARPENTEUR AVE SAINT PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $229 | $57 | $286 | 0.81% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $115 | $28 | $143 | 0.40% |
| JON OLSON3 | 8662 CARRIAGE HILL RD SAVAGE, MN 55378 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $102 | — | $102 | 0.29% |
| JEFFREY D HARNED3 Filed as: JEFFREY LYLES | 3872 BALLANTRAE RD EAGAN, MN 55122 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $71 | — | $71 | 0.20% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $30 | $33 | $63 | 0.18% |
| DESIREE WENDELL3 | 39050 HARDER PKWY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $48 | — | $48 | 0.14% |
| WILLIAM D STAEDKE3 | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $28 | $5 | $33 | 0.09% |
| DANA MARIE MOWATT3 | 237010 S WESTERN AVE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $22 | — | $22 | 0.06% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $22 | — | $22 | 0.06% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DRIVE SE ST MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $20 | — | $20 | 0.06% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $16 | — | $16 | 0.05% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $5 | $4 | $9 | 0.03% |
| SABRINA S RAMOS3 | 13750 W. COLONIAL DR WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $5 | — | $5 | 0.01% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $4 | — | $4 | 0.01% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $1 | — | $1 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC. | 80 SOUTH 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $1K | $0 | $1K | 10.72% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 13.52% |
| DALY KAHNERT & ASSOCIATES INC.4 | 14736 E LOOKOUT LEDGE SUITE 116 FOUNTAIN HILLS, AZ 85268 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $441 | — | $441 | 4.86% |
| ENERGY INSURANCE AGENCY INC4 Filed as: ENERGY INSURANCE AGENCY | 3008 ATKINSON AVE LEXINGTON, KY 40509 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $86 | — | $86 | 0.95% |
| LAWTON BENEFITS GROUP LLC4 Filed as: LAWTON BENEFITS GROUP | 526 164TH AVE APT 208 SOMERSET, WI 54025 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $44 | — | $44 | 0.48% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | THE PAUL REVERE LIFE INSURANCE COMPANY | $27 | — | $27 | 4.00% |
| MARIA VERONICA JARQUE3 | 701 WRELTON DRIVE UNIT E SAN DIEGO, CA 92037 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | — | $14 | 2.07% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | — | $7 | 1.04% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN MOFFATT LUCUS | 2650 ACORN RUN VICTORIA, MN 55386 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.74% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | — | $2 | 0.30% |
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 | 360 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 360 | 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. | 269 | $13K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 360 | $102K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 360 | $102K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 360 | $102K |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 360 | $185K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 360 | — |
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.