| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC. Filed as: THE HAYS GROUP INC | 80 S 8TH ST IDS CENTER, STE 700 MINNEAPOLIS, MN 55402 | HCC LIFE INSURANCE COMPANY | $33K | — | $33K | 12.70% |
| HAYS COMPANIES, INC. Filed as: THE HAYES BENEFIT GROUP | 80 S 8TH ST 700 MINNEAPOLIS, MN 55402 | USABLE LIFE/MII LIFE INC | $2K | — | $2K | 10.00% |
| BENEUSA LLC | 1851 LAKE DRIVE WEST SUITE 350 CHANHASSEN, MN 55317 | USABLE LIFE/MII LIFE INC | $838 | — | $838 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILSON MCSHANE CORP EIN 41-0956552 ADMINISTRATIVE FEES | Claims processing; Contract Administrator Service code 12 | 3001 METRO DR, STE 500 BLOOMINGTON, MN 55425 | $255K |
| BCBSMN, INC DBA BLUE CROSS AND BLUE EIN 41-0984460 ADMINISTRATIVE FEES | Other fees; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | PO BOX 64560 ST. PAUL, MN 55164 | $175K |
| MCGRANN SHEA CARNIBAL STRAUGHN LAMB EIN 41-1654544 PLAN ATTORNEY | Legal Service code 29 | 800 NICOLLET MALL 2600 MINNEAPOLIS, MN 55402 | $23K |
| LETHERT, SKWIRA, SCHUTLZ, & CO LLP EIN 41-0738189 AUDITOR | Accounting (including auditing) Service code 10 | 170 7TH PL E ST PAUL, MN 55101 | $19K |
| STANDARD VALUATIONS EIN 41-1327339 INVESTMENT ADVISOR | Investment advisory (plan) Service code 27 | 790 CLEVELAND AVE S SAINT PAUL, MN 55116 | $19K |
| DELTA DENTAL EIN 41-1905554 CLAIMS PROCESSING | Claims processing Service code 12 | 500 WASHINGTON AVE S MINNEAPOLIS, MN 55415 | $13K |
| CVS CAREMARK EIN 05-0340626 CLAIMS PROCESSING | Claims processing Service code 12 | 1 CVS DRIVE WOONSOCKET, RI 02895 | $13K |
| UNION BANK & TRUST EIN 41-1267434 CUSTODIAN | Custodial (securities) Service code 19 | 312 CENTRAL AVE SE MINNEAPOLIS, MN 55414 | $10K |
| UNITED ACTUARIAL SERVICES, INC EIN 35-2156428 ACTUARY | Actuarial Service code 11 | 11590 N MERIDIAN ST 610 CARAMEL, IN 460324529 | $9K |
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 | 376 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 18 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 394 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | USABLE LIFE/MII LIFE INC | 422 | $17K |
| Short-term disability | USABLE LIFE/MII LIFE INC | 422 | $17K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 354 | $262K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 422 | — |
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.