| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S. 8TH STREET IDS CENTER STE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $38K | $12K | $49K | 8.26% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S. 8TH STREET STE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $777 | $40 | $817 | 2.56% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $538 | $70 | $608 | 1.90% |
| ELIZABETH MARIE LANGEVIN3 | 689 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $115 | $7 | $122 | 0.38% |
| CAROL BARNES3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $61 | $10 | $71 | 0.22% |
| ALEXANDER OTTONIEL CANAS3 | 26123 BOUQUET CANYON RD SANTA CLARITA, CA 91350 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $53 | $15 | $68 | 0.21% |
| JERRY A EDGAR3 | 7021 S 38TH ST LINCOLN, NE 68516 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | — | $59 | 0.18% |
| FRANCISCO X CABRERA3 | P.O. BOX 1871 FRISCO, TX 75034 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | — | $56 | 0.18% |
| JAMES SNOW3 | 286 CASTLEGATE ROAD MACON, GA 31210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $40 | — | $40 | 0.13% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $35 | $3 | $38 | 0.12% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $31 | $6 | $37 | 0.12% |
| ANDREW JAMIN GRIMSLEY3 | 0639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.10% |
| BRIDGET ZUNIGA3 | 14608 W 62ND ST SHAWNEE, KS 66216 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $25 | — | $25 | 0.08% |
| STERLING WEALTH MANAGEMENT LLC3 | W175 N11163 STONEWOOD DR GERMANTOWN, WI 53022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $18 | — | $18 | 0.06% |
| TAMARA ANN BUSCHER3 | 1318 S WINTERBROOK OLATHE, KS 66062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $17 | — | $17 | 0.05% |
| JOHN D EVANGELISTA3 | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $5 | $14 | 0.04% |
| JOSEPH M TAMER3 | 6500 PAPERMILL DR KNOXVILLE, TN 37919 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.04% |
| PLM SOLUTIONS INC3 | 557 GRAVES ROAD WEDOWEE, AL 36278 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | — | $9 | 0.03% |
| WORLD INSURANCE ASSOCIATES LLC3 Filed as: KLH INSURANCE INC | 6481 TANAGER LANE EDEN PRAIRIER, MN 55346 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| MARILYN B BOWLING3 | 19204 WEST 102ND ST LENEXA, KS 66220 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| MAUREEN E CONRAN3 | 8575 WEST 110TH STREET OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| TERRY ALLEN SMITH3 | 14070 S DARNELL CT OLATHE, KS 66062 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | — | $3 | 0.01% |
| CARRIE S FLATEN3 | 2606 86TH CT W NORTHFIELD, MN 55057 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| RON BOWLING3 | 8575 W 110TH ST OVERLAND PARK, KS 66210 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| BROCKSTAR LLC3 | 2561 FALCON RIDGE DRIVE GRAYSON, GA 30017 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| SPECTRUM SOLUTIONS INC3 | 213 GOVERNOR WALK KATHLEEN, GA 31047 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | — | $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 | 824 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 828 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HARTFORD LIFE AND ACCIDENT | 824 | $599K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 824 | $631K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 59 | $32K |
| Long-term disability(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 824 | $631K |
| Other(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 824 | $631K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 824 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.