| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC - MN | 80 SOUTH 8TH STREET #700 MISSEAPOLIS, MN 55402 | DELTA DENTAL OF MISSOURI | — | — | $0 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST, STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.00% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST, STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 6.20% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST, STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.97% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 S 8TH ST, STE 700 MINNEAPOLIS, MN 55402 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $829 | $829 | 5.98% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH USA INC - JW TERRILL | 6160 GOLDEN HILLS DR MINNEAPOLIS, MN 55416 | ADVANTICA INSURANCE COMPANY | — | — | $0 | 0.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC - MN | 80 S 8TH ST., SUITE 700 MINNEAPOLIS, MN 55402 | ADVANTICA INSURANCE COMPANY | — | — | $0 | 0.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Claims processing; Float revenue; Other fees; Direct payment from the plan Service code 12 | — | $386K |
| UMR, INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $29K |
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 | 205 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 206 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MISSOURI | 288 | $81K |
| Vision | ADVANTICA INSURANCE COMPANY | 199 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 205 | $14K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 88 | $29K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 106 | $26K |
| Stop-loss / reinsurancereinsurance | UNITED STATES FIRE INSURANCE COMPANY | 174 | $261K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 78 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 288 | — |
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.