| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $15K | $3K | $18K | 11.70% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $4K | $2K | $6K | 6.01% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9K | $119 | $9K | 11.39% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $505 | $3K | 3.99% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $781 | $57 | $838 | 1.07% |
| DAVID HAMPTON3 | 4910 W ARLINGTON PARK BLVD FT. WAYNE, IN 46835 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $352 | $12 | $364 | 0.46% |
| CLARICE R MIMS3 | 172-90 HIGHLAND AVENUE JAMAICA ESTATES, NY 11432 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $313 | $45 | $358 | 0.46% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $285 | $62 | $347 | 0.44% |
| KAREN BOHLER3 | 12810 PRIMROSE LANE EDEN PRAIRIE, MN 55344 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $201 | $35 | $236 | 0.30% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $169 | $3 | $172 | 0.22% |
| LAURA B WETT3 | 8496 100TH ST E NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $155 | $7 | $162 | 0.21% |
| BRAD BIEL3 | 1050 WALL STREET WEST LYNDHURST, NJ 07071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | $75 | $98 | 0.12% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | — | $92 | 0.12% |
| DAVID J MCCLELLAN3 Filed as: DAVID E WYATT | 1011 N 49TH AVE OMAHA, NE 68132 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $5 | $70 | 0.09% |
| JILL R LAMBERT3 Filed as: JILL DICE-MALGIER | 17 MIDBRIDGE DRIVE MEDFORD, NJ 08055 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 0.07% |
| AARON VANPELT INC3 Filed as: AARON VANPELT INC. | 9619 SPRUCE LANE FISHERS, IN 46038 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $17 | $45 | 0.06% |
| DANA MARIE MOWATT3 | 23701 S WESTERN AVE #112 TORRANCE, CA 90501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.04% |
| ALLYN INCORPORATED3 | 3013 BROOKFIELD LANE CLEARWATER, FL 33761 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $28 | $4 | $32 | 0.04% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55352 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $14 | $28 | 0.04% |
| EVELYN GARCIA3 | 1562 1ST AVE NEW YORK, NY 10028 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 0.03% |
| JACKIE LEE KELLER3 | 7622 SERGI CANYON DRIVE INDIANAPOLIS, IN 46217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $5 | $18 | 0.02% |
| ROBERT E ELLIS3 | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10 | $5 | $15 | 0.02% |
| DAWN RENEE MORGAN3 | 6413 DUNMOOR DR PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.01% |
| MARK J ROBISON3 | 1255 KIENAS ROAD KALISPELL, MT 59901 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | $2 | $9 | 0.01% |
| JOHN W COURT3 | 1326 SHALIMAR DRIVE FT. WAYNE, IN 46845 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.01% |
| TWILA MORRIS3 | 23 BLUE JAY DRIVE CLEMENTON, NJ 08021 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| R & B ENROLLMENT SERVICES INC3 Filed as: R&B ENROLLMENT SERVICES | PO BOX 3216 CRESTLINE, CA 92325 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| COACH CONCEPTS INC3 Filed as: COACH CONCEPTS INC. | 9500 KOGER BLVD ST. PETERSBURG, FL 33702 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.00% |
| PREMIER WORKSITE SOLUTIONS INC3 Filed as: PREMIER WORKSITE SOLUTIONS INC. | 806 NW 79TH ST VANCOUVER, WA 98665 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $1 | $2 | 0.00% |
| MICHAEL J PERRI3 | 775 ROUTE 70 EAST MARLTON, NJ 08053 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| SAMUEL TADLOCK3 | 3713 LYNWOOD DRIVE HIGHLAND, CA 92346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $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 | 641 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 644 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 351 | $71K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 641 | $155K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 641 | $108K |
| Other(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 641 | $233K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 641 | — |
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.