| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 SOUTH 8TH STREET IDS CENTER STE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $33K | — | $33K | 6.93% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC. | 80 SO. 8TH ST. STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $63 | $1K | 3.73% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $723 | $204 | $927 | 2.95% |
| JERRY A EDGAR3 | 7021 S 38TH ST. LINCOLN, NE 68516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $227 | $10 | $237 | 0.75% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $154 | $16 | $170 | 0.54% |
| TAMARA ANN BUSCHER3 | 1318 S WINTERBROOK OLATHE, KS 66062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | $7 | $109 | 0.35% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $55 | $21 | $76 | 0.24% |
| FRANCISCO X CABRERA3 | P.O. BOX 1871 FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $67 | — | $67 | 0.21% |
| JAMES SNOW3 Filed as: JAMES G SNOW | 286 CASTLEGATE ROAD MACON, GA 31210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $51 | — | $51 | 0.16% |
| CAROL BARNES3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $39 | $6 | $45 | 0.14% |
| ANDREW JAMIN GRIMSLEY3 | 111 RAMBLING CREEK DR SE SAINT MICHAEL, MN 55376 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $43 | — | $43 | 0.14% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $1 | $42 | 0.13% |
| BRIDGET ZUNIGA3 | 14608 W 62ND ST SHAWNEE, KS 66216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.09% |
| STERLING WEALTH MANAGEMENT LLC3 | C/O CHARLES JAEGER BROOKFIELD, WI 53045 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | — | $21 | 0.07% |
| RON BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | $7 | $20 | 0.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT E ELLIS | 11261 WRIGHT CIRCLE OMAHA, NE 68144 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $5 | $19 | 0.06% |
| CRISS BUTLER3 | 4924 EASTRIDGE DR OMAHA, NE 68134 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | $2 | $16 | 0.05% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $14 | — | $14 | 0.04% |
| PLM SOLUTIONS INC3 | 3244 WINTERBERRY CIRCLE MARIETTA, GA 30062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11 | — | $11 | 0.03% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIE, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $8 | — | $8 | 0.03% |
| MARILYN B BOWLING3 | 8447 SUMMIT STREET LENEXA, KS 66215 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| MAUREEN E CONRAN3 | 8575 WEST 10TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| TERRY ALLEN SMITH3 | 14070 S DARNELL CT OLATHE, KS 66062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.01% |
| JUDY L CHANDLER3 | 8831 HEISKELL ROAD POWELL, TN 37849 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| SPECTRUM SOLUTIONS INC3 | 213 GOVERNOR WALK KATHLEEN, GA 31047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| TBX EMPLOYEE BENEFITS LLC3 | 1201 ELM ST STE 4250 DALLAS, TX 75270 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.00% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
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 | 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 |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 778 | $503K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 63 | $31K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 778 | $503K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 778 | $503K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 778 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.