| 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 | $125K | $0 | $125K | 18.12% |
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $10K | $0 | $10K | 9.89% |
| MARC A GROVE3 Filed as: MARC GROVE | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $609 | $13 | $622 | 1.98% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $508 | $11 | $519 | 1.65% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $325 | $7 | $332 | 1.06% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $117 | $0 | $117 | 0.37% |
| ELIZABETH MARIE LANGEVIN3 | 698 W. LARPENTEUR AVE ST PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $103 | $0 | $103 | 0.33% |
| JILL R LAMBERT3 Filed as: JILL LAMBERT | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $70 | $0 | $70 | 0.22% |
| ZACHARY JAMES HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | $0 | $66 | 0.21% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE | 6505 DEMPSEY AVE SW WAVERLY, MN 55390 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $36 | $1 | $37 | 0.12% |
| JENNIFER GROVE3 | 25900 AUTMN WAY ROBERTS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $0 | $30 | 0.10% |
| CARRIE S FLATEN3 | 2606 86 CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $0 | $28 | 0.09% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | $0 | $25 | 0.08% |
| SAFETY NET BENEFITS INC3 | 641 SE NORSEMEN DR PORT ST LUCIE, FL 34984 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $0 | $22 | 0.07% |
| TR INSURANCE ADVISORS INC3 | 1009 EIGHTH AVE NE WASECA, MN 56093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | $2 | $17 | 0.05% |
| SUSAN FONTANA FLYNN3 | 8814 EAGLE POINT DRIVE KNOXVILLE, TN 37931 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | $0 | $17 | 0.05% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5 | $0 | $5 | 0.02% |
| ROBERT SCOTT BRUNER3 | 24620 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.01% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVENUE STATEN ISLAND, NY 10314 | ACE AMERICAN INSURANCE COMPANY | $0 | $4K | $4K | 20.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN | 901 MARQUETTE AVE. SUITE 1800 MINNEAPOLIS, MN 55402 | ACE AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 15.00% |
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 | 1,409 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 5 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,414 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,245 | $723K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 1,020 | $99K |
| Life insurance | STANDARD INSURANCE COMPANY | 1,245 | $692K |
| Short-term disability | STANDARD INSURANCE COMPANY | 1,245 | $692K |
| Long-term disability | STANDARD INSURANCE COMPANY | 1,245 | $692K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 1,409 | $714K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,409 | — |
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.