| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | $56K | $1K | $58K | 3.06% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80TH SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | DELTA DENTAL | $2K | — | $2K | 1.63% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | SUN LIFE ASSURANCE COMPANY OF CANADA | $9K | — | $9K | 9.60% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFIT GROUP LLC | 80 S 8TH ST, STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 10.02% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $354 | — | $354 | 2.60% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $119 | — | $119 | 0.87% |
| MEGAN MOFFATT LUCAS3 Filed as: MEGAN MOFFATT LEWIS | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.54% |
| CAROLYN GROVER3 Filed as: CAROLYN GROVE | 206 FOX CHAPEL DRIVE IRMO, SC 29063 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.27% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY ST CLOUD, MN 56301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $37 | — | $37 | 0.27% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 3357 POLK STREET NE MINNEAPOLIS, MN 55418 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.07% |
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 | 192 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 199 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 264 | $1.9M |
| Dental | DELTA DENTAL | 145 | $108K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $92K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $92K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $92K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 167 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.