| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HCC LIFE INSURANCE COMPANY | $22K | $5K | $27K | 12.46% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF FLORIDA, INC. | PO BOX 748422 ATLANTA, GA 303748422 | HCC LIFE INSURANCE COMPANY | — | $868 | $868 | 0.40% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | USABLE LIFE | $2K | — | $2K | 9.40% |
| BENEUSA LLC3 | 1851 LAKE DRIVE WEST SUITE 350 CHANHASSEN, MN 55317 | USABLE LIFE | $785 | — | $785 | 4.70% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILSON MCSHANE CORPORATION EIN 41-0956552 NONE | Accounting (including auditing); Contract Administrator; Claims processing Service code 10 | — | $231K |
| BCBSMN EIN 41-0984460 NONE | Contract Administrator; Claims processing; Other fees; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $168K |
| MCGRANN SHEA CARNIVAL STRAUGHN LAMB EIN 41-1654544 NONE | Legal Service code 29 | — | $35K |
| LETHERT, SKWIRA, SCHULTZ, & CO LLP EIN 41-0738189 NONE | Accounting (including auditing) Service code 10 | — | $24K |
| STANDARD VALUATIONS EIN 41-1327339 NONE | Investment advisory (plan) Service code 27 | — | $16K |
| DDMN ASO, LLC EIN 41-1852523 NONE | Claims processing; Contract Administrator Service code 12 | — | $13K |
| NICOLLET INVESTMENT MANAGEMENT EIN 41-1958471 NONE | Investment management fees paid directly by plan Service code 51 | — | $12K |
| UNION BANK AND TRUST EIN 41-1267434 NONE | Custodial (securities); Account maintenance fees Service code 19 | — | $10K |
| UNITED ACTUARIAL SERVICES INC EIN 35-2156428 NONE | Actuarial Service code 11 | — | $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 | 472 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | USABLE LIFE | 412 | $17K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 395 | $215K |
| Other | USABLE LIFE | 412 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 412 | — |
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.