| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| 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 | 3.98% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC - MN | 80 SOUTH 8TH ST #700 MINNEAPOLIS, 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 | — | $1K | $1K | 3.87% |
| 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 | — | $1K | $1K | 4.15% |
| 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% |
| 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 | — | $539 | $539 | 4.17% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUMRX, INC. EIN 33-0441200 PHARMACY BENEFIT MGMT | Float revenue; Other fees; Direct payment from the plan; Claims processing Service code 12 | — | $461K |
| UMR, INC. EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $120K |
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 | 200 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 200 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF MISSOURI | 144 | $30K |
| Vision | ADVANTICA INSURANCE COMPANY | 221 | $13K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 200 | $13K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 84 | $28K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $24K |
| Stop-loss / reinsurancereinsurance | PAN AM LIFE INSURANCE COMPANY | 171 | $328K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 74 | $41K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 221 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.