| 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 | $23K | $3K | $26K | 18.86% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $8K | 18.86% |
| 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 | $549 | $3K | 7.70% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 886 POPLAR LN WATERTOWN, MN 55388 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $1K | $195 | $1K | 3.09% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $982 | $152 | $1K | 2.92% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $574 | $354 | $928 | 2.39% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $281 | $76 | $357 | 0.92% |
| ZACKARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $310 | $10 | $320 | 0.82% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE SAINT PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $246 | $40 | $286 | 0.74% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $133 | $51 | $184 | 0.47% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $34 | $43 | $77 | 0.20% |
| DESIREE WENDELL3 | 39050 HARDER PKWY NORTH BRANCH, MN 55056 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $49 | $0 | $49 | 0.13% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $20 | $0 | $20 | 0.05% |
| DANA MARIE MOWATT3 | 237010 S WESTERN AVE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $18 | $0 | $18 | 0.05% |
| WILLIAM D STAEDKE3 | PO BOX 140803 BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $15 | $2 | $17 | 0.04% |
| JENNIFER B WILLIAMS3 | 17594 WIEDMAN WAY EDEN PRAIRIE, MN 55347 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $16 | $0 | $16 | 0.04% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DRIVE SE ST MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $9 | $0 | $9 | 0.02% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $3 | $0 | $3 | 0.01% |
| KELLY W PUGH3 | 7367 S 286TH EAST AVE BROKEN ARROW, OK 74014 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $1 | $0 | $1 | 0.00% |
| CARRIE S FLATEN3 | PO BOX 140803 NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $1 | $0 | $1 | 0.00% |
| JEFFREY D HARNED3 Filed as: JEFFREY LYLES | 3872 BALLANTRAE RD EAGAN, MN 55122 | COLONIAL LIFE & ACCIDENT INSURANCE COMAPNY | $0 | $0 | $0 | 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. | $2K | $0 | $2K | 12.18% |
| STEVE BAKER4 | 153 ESTHER DRIVE COCOA BEACH, FL 32931 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 16.35% |
| DALY KAHNERT & ASSOCIATES INC.4 | 14736 E LOOKOUT LEDGE SUITE 116 FOUNTAIN HILLS, AZ 85268 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $334 | $0 | $334 | 3.38% |
| ENERGY INSURANCE AGENCY INC4 Filed as: ENERGY INSURANCE AGENCY | 3008 ATKINSON AVE LEXINGTON, KY 40509 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $25 | $0 | $25 | 0.25% |
| LAWTON BENEFITS GROUP LLC4 Filed as: LAWTON BENEFITS GROUP | 526 164TH AVE APT 208 SOMERSET, WI 54025 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $23 | $0 | $23 | 0.23% |
| 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 | $0 | $27 | 4.00% |
| MARIA VERONICA JARQUE3 | 2325 1/2 N ROCKWELL ST CHICAGO, IL 60647 | THE PAUL REVERE LIFE INSURANCE COMPANY | $14 | $0 | $14 | 2.07% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | THE PAUL REVERE LIFE INSURANCE COMPANY | $7 | $0 | $7 | 1.04% |
| MEGHAN MOFFATT LUCAS3 Filed as: MEGHAN MOFFATT LUCUS | 2650 ACORN RUN VICTORIA, MN 55386 | THE PAUL REVERE LIFE INSURANCE COMPANY | $5 | $0 | $5 | 0.74% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST PAUL, MN 55113 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2 | $0 | $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 | 443 | 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) | 443 | 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. | 279 | $18K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 483 | $140K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 483 | $140K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 483 | $140K |
| Other(5 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 483 | $234K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 483 | — |
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.