| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP, LLC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | THE STANDARD INSURANCE COMPANY | $12K | $16K | $27K | 5.53% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 S 8TH ST SUITE 700 MPLS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $399 | $6K | 5.31% |
| MARC A GROVE3 Filed as: MARC GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $982 | $4K | 3.30% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $746 | $3K | 2.20% |
| ROSE MARY GOODMAN3 | 5200 HOLLY LANE N #4 PLYMOUTH, MN 55446 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $38 | $1K | 1.11% |
| SAFETY NET BENEFITS INC3 | 8100 OZARK DRIVE SAN MARCOS, TX 78666 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $760 | $19 | $779 | 0.68% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $595 | $137 | $732 | 0.64% |
| ELIZABETH MARIE LANGEVIN3 | 698 W. LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $528 | $146 | $674 | 0.59% |
| JENNIFER GROVE3 | 25900 AUTMN WAY ROBERTS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $480 | — | $480 | 0.42% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $357 | $78 | $435 | 0.38% |
| ZACHARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $280 | $22 | $302 | 0.26% |
| TYLOR DOUGLAS NOLL3 | 13246 POSTIER DRIVE NW ORONOCO, MN 55960 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $233 | $7 | $240 | 0.21% |
| MPART BENEFITS INC3 | 4621 GLEN HEATHER DR FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $115 | $112 | $227 | 0.20% |
| JON OLSON3 | 5650 W 36 ST APT 509 ST. LOUIS PARK, MN 55416 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $171 | $9 | $180 | 0.16% |
| PHILIP GOODMAN3 | 13480 60 PL N UNIT 99 PLYMOUTH, MN 55446 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $177 | $0 | $177 | 0.16% |
| KELLY CAROLE LARSON3 Filed as: KELLY CAROLOE LARSON | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $157 | $4 | $161 | 0.14% |
| CARRIE S FLATEN3 | 2606 86 CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $132 | $8 | $140 | 0.12% |
| CURTIS LARSON3 | 11626 YUKON ST NW COON RAPIDS, MN 55433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | $2 | $94 | 0.08% |
| BRIAN MATTHEW HEINZEN3 | 16921 SOUTH SHORE LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $88 | $0 | $88 | 0.08% |
| SUSAN FONTANA FLYNN3 | 8814 EAGLE POINT DR KNOXVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $76 | $9 | $85 | 0.07% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE | 3357 POLK ST NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $17 | $82 | 0.07% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $69 | $11 | $80 | 0.07% |
| SABRINA S RAMOS3 Filed as: SABRINA RAMOS | 13750 COLONIAL DRIVE SUITE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $68 | $3 | $71 | 0.06% |
| MELONY LEE MICHAELS3 | 4200 WEDGEWOOD LANE N PLYMOUTH, MI 55442 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $0 | $61 | 0.05% |
| GRANT CREIGHTON ROCKWOOD3 | 2832 HARRIET AVE MPLS, MN 55408 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $0 | $61 | 0.05% |
| YVONNE BRUNER3 Filed as: YVONNE BUNER | 304 S 5TH ST MONTEVIDEO, MN 56265 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $0 | $39 | 0.03% |
| BRAD BIEL3 | 1050 WALL ST WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | $23 | $34 | 0.03% |
| ROBERT SCOTT BRUNER3 | 987 LACY CT BELLE PLAINE, MN 56011 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | $11 | $29 | 0.03% |
| NELS COREY JOHNSON3 | 25262 SLOTH ST NW ZIMMERMAN, MN 55398 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.01% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE SUITE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $16 | $1 | $17 | 0.01% |
| SAMUEL RANDOLPH BEARD3 | 13048 AVOCET ST NW COON RAPIDS, MN 55433 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.01% |
| MAX MARTIN LINDSAY3 | 2911 STAGE RUN DRIVE HIXSON, TN 37343 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $2 | $11 | 0.01% |
| WILLIAM RENNARD3 | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $5 | $11 | 0.01% |
| NORWOOD BENEFIT SERVICES INC3 | 6478 LONG BREEZE RD ORLANDO, FL 32810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $0 | $6 | 0.01% |
| ENROLLMENT SOLUTIONS LTD3 Filed as: ENROLLMENT SOLUTIONS | 65 BURBANK RD SUTTON, MA 01590 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $2 | $4 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP, LLC | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
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 | 1,009 | 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) | 1,009 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 219 | $114K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 394 | $73K |
| Life insurance | THE STANDARD INSURANCE COMPANY | 1,009 | $490K |
| Long-term disability | THE STANDARD INSURANCE COMPANY | 1,009 | $490K |
| Other | THE STANDARD INSURANCE COMPANY | 1,009 | $490K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,009 | — |
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.