| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP, LLC | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $42K | $14K | $56K | 7.61% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP, LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | $1K | $11K | 19.75% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP, LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | ZURICH AMERICAN INSURANCE COMPANY | $4K | — | $4K | 15.00% |
| REUBEN WARNER ASSOCIATES, INC.3 | 1655 RICHMOND AVE. STATEN ISLAND, NY 10314 | ZURICH AMERICAN INSURANCE COMPANY | — | $4K | $4K | 15.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFITS GROUP, LLC | 80 SO. 8TH ST. SUITE 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4K | $293 | $4K | 22.20% |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 200 | $54K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 1,771 | $65K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 1,216 | $758K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 1,216 | $740K |
| Other(3 contracts, 3 carriers) | HARTFORD LIFE AND ACCIDENT | 1,216 | $794K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,771 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.