| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $46K | $6K | $52K | 23.52% |
| MICHELLE J HALLER3 | 913 HUNTINGTON WAY JORDAN, MN 55353 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22K | $19K | $41K | 18.73% |
| MARC A GROVE3 | 25900 AUTUMN WAY ROGERS, MN 55374 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $11K | $9K | $19K | 8.82% |
| SANDRA SIMS3 | 13750 W COLONIAL DRIVE STE 350 WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $743 | $6K | 2.62% |
| ELIZABETH MARIE LANGEVIN3 | 698 W LARPENTEUR AVE ST. PAUL, MN 55113 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $2K | $4K | 2.03% |
| MEGHAN MOFFATT LUCAS3 | 2650 ACORN RUN VICTORIA, MN 55386 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $1K | $4K | 1.84% |
| MARIA VERONICA JARQUE3 | 4525 GEORGIA ST SAN DIEGO, CA 92116 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $821 | $4K | 1.83% |
| JENNIFER COLLEEN DYNAN3 | 13674 BRONZE PARKWAY ROSEMOUNT, MN 55068 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $217 | $3K | 1.23% |
| JILL R LAMBERT3 | 12741 JEFFERSON ST NE BLAINE, MN 55434 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $834 | $3K | 1.23% |
| SABRINA S RAMOS3 | 13750 W COLONIAL DRIVE WINTER GARDEN, FL 34787 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $512 | $3K | 1.21% |
| DAWN RENEE MORGAN3 | 6413 DUNMOOR DR PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $318 | $2K | 1.10% |
| ROBERT ANTHONY MARTIN3 | PO BOX 1516 FLORENCE, KY 41022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $851 | $2K | 1.09% |
| DEIRDE B HOEHN3 | 30885 FRESH POND WAY OCEAN VIEW, DC 19970 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $313 | $2K | 1.00% |
| KELLY CAROLE LARSON3 | 11026 ZUMBROTA CT NE BLAINE, MN 55449 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $68 | $1K | 0.55% |
| WILLIAM RENNARD3 Filed as: WILLIAM RENARD | 3001 ALOMA AVE WINTER PARK, FL 32792 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $585 | $216 | $801 | 0.36% |
| NORWOOD BENEFIT SERVICES INC3 | 6478 LONG BREEZE RD ORLANDO, FL 32810 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $585 | $45 | $630 | 0.29% |
| WENDY DAWN PACK3 | 16109 WATT WAY RAMONA, CA 92065 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $515 | $1 | $516 | 0.23% |
| KYLE HARDING3 | 520 W 12TH ST TEXARKANA, TX 75501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $309 | $161 | $470 | 0.21% |
| ARTHUR LEE SLAYLINE3 | 46 KYLES LANE APT. 1 FORT THOMAS, KY 41075 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $260 | $162 | $422 | 0.19% |
| JGBENEFITS CONSULTANTS3 | 12300 FORD ROAD FARMERS BRANCH, TX 75234 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $344 | $55 | $399 | 0.18% |
| CLARICE D LEWIS LLC3 | 8631 STONEFACE RD CHARLOTTE, NC 28214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $336 | $40 | $376 | 0.17% |
| ANDREW JAMIN GRIMSLEY3 | 1639 GOETTENS WAY SAINT CLOUD, MN 56301 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $207 | $7 | $214 | 0.10% |
| RENE ADRIAN RODRIGUEZ3 | 1814 E BELL RD UNIT 2009 PHOENIX, AZ 85022 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $106 | $13 | $119 | 0.05% |
| ROBERT SCOTT BRUNER3 | 24260 E CEDAR LAKE DR NEW PRAGUE, MN 56071 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $38 | $58 | $96 | 0.04% |
| DAVID MASON DOKELL3 | 159 BEACON DR MOORESVILLE, NC 28117 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $29 | $94 | 0.04% |
| CD FRAZIER ASSOCIATES INC3 | 8631 STONEFACE RD CHARLOTTE, NC 28214 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $56 | $16 | $72 | 0.03% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: KERWIN VAUGHN BROWN | 1939 E MISSOURI AVE APT 5 PHOENIX, AZ 85016 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $19 | $10 | $29 | 0.01% |
| DAVID W OTTINGER3 | 111 CURRY HILL RD LEMONT FURNACE, PA 15456 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $9 | $2 | $11 | 0.00% |
| KIMMON R GUSEMAN3 | 47 EAST FAYETTE STREET UNIONTOWN, PA 15401 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.00% |
No Schedule C service providers reported on this filing.
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 | 383 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 383 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 402 | $221K |
| Short-term disability | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 402 | $221K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 402 | $221K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 402 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.