| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET, STE 700 MINNEAPOLIS, MN 55402 | HCC LIFE INSURANCE COMPANY | $40K | — | $40K | 7.87% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| WILSON-MCSHANE CORPORATION EIN 41-0956552 NONE | Contract Administrator; Claims processing; Copying and duplicating Service code 12 | — | $633K |
| UMR, INC. EIN 39-1995276 NONE | Other fees; Contract Administrator Service code 13 | — | $517K |
| T.E.A.M., LLC EIN 81-4050818 NONE | Contract Administrator Service code 13 | — | $68K |
| DDMN ASO LLC EIN 41-1852523 NONE | Contract Administrator Service code 13 | — | $52K |
| BENEVELLE CONSULTING CORPORATION EIN 88-3202021 NONE | Actuarial Service code 11 | — | $41K |
| LEGACY PROFESSIONALS LLP EIN 32-0043599 NONE | Accounting (including auditing) Service code 10 | — | $23K |
| SHUMAKER, LOOP & KENDRICK EIN 34-4439491 NONE | Legal Service code 29 | — | $21K |
| KUTAK ROCK, LLP EIN 47-0597598 NONE | Legal Service code 29 | — | $17K |
| SEGALL BRYANT & HAMILL EIN 35-2679129 NONE | Investment management; Investment management fees paid directly by plan Service code 28 | — | $10K |
| US BANK EIN 31-0841368 NONE | Custodial (securities); 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 | 1,797 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 88 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,885 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 88 | $400K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,748 | $94K |
| Prescription drug | SIERRA HEALTH AND LIFE INSURANCE COMPANY, INC. | 88 | $400K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 1,788 | $508K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 2,748 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,748 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.