| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFIT GROUP LLC | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | BLUECROSS AND BLUESHIELD OF MN | $40K | — | $40K | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BCBSMN, INC. EIN 41-0984460 NONE | Claims processing; Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $289K |
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Accounting (including auditing); Contract Administrator Service code 10 | — | $264K |
| HEALTH DYNAMICS EIN 39-1923786 NONE | Other services Service code 49 | — | $44K |
| PRIME THERAPEUTICS EIN 26-0076803 NONE | Other services; Claims processing; Other fees; Float revenue Service code 12 | — | $29K |
| ANDREW, BRANSKY, & POOLE, P.A. EIN 41-1502219 NONE | Legal Service code 29 | — | $25K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $19K |
| UNITED ACTUARIAL SERVICES, INC. EIN 35-2156428 NONE | Actuarial Service code 11 | — | $10K |
| TRANSAMERICA RETIREMENT SOLUTIONS EIN 13-3689044 NONE | Custodial (securities); Distribution (12b-1) fees; Shareholder servicing fees; Investment management; Recordkeeping fees; Float revenue Service code 19 | — | $8K |
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 | 770 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 387 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS AND BLUESHIELD OF MN | 516 | $1.8M |
| Prescription drug | BLUECROSS AND BLUESHIELD OF MN | 516 | $1.8M |
| Stop-loss / reinsurancereinsurance | BLUECROSS AND BLUESHIELD OF MN | 849 | $400K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 849 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.