| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC - AAXR | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | BLUE CROSS BLUE SHIELD OF FLORIDA | $201K | — | $201K | 6.00% |
| PCF INSURANCE SERVICES OF THE WEST3 | 7807 BAYMEADOWS RD E STE 301 JACKSONVILLE, FL 32256 | PRINCIPAL LIFE INSURANCE COMPANY | $31K | — | $31K | 7.50% |
| HAYS COMPANIES, INC.3 | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | PRINCIPAL LIFE INSURANCE COMPANY | $11K | — | $11K | 2.71% |
| PCF INSURANCE SERVICES OF THE WEST3 | DBA THE DELTA PORTA GROUP JACKSONVILLE, FL 32256 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $21 | $3K | 13.36% |
| HEATHER WOMBLE LLC3 | 2409 PIRATE CT JACKSONVILLE, FL 32224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $733 | $2K | $2K | 10.14% |
| WHITNEY RENEE DAVIS3 | 2409 PIRATE CT JACKSONVILLE, FL 32224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $406 | $1K | $2K | 8.15% |
| ALDEN D MCGEE3 | 3657 RICHMOND ST JACKSONVILLE, FL 32205 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $584 | $2K | 8.09% |
| HOWARD HOROWITZ3 | 2610 ALCOTT ST CARMEL, IN 46032 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $515 | $190 | $705 | 3.02% |
| ALYSON MARIE MCMAHON3 | 2127 GRASSY BASIN CT JACKSONVILLE, FL 32224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $295 | $133 | $428 | 1.83% |
| CHRISTI FRAUENHEIM WHEELER3 | 2937 SANS PAREIL ST JACKSONVILLE, FL 32246 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $327 | — | $327 | 1.40% |
| JUNE D WALENTA3 | 3591 KERNAN BLVD APT 803 JACKSONVILLE, FL 32224 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $275 | — | $275 | 1.18% |
| JEFFREY MOTSCO3 | 15612 LINDEN GROVE LN WOODBINE, MD 21797 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $41 | $24 | $65 | 0.28% |
| TANYA MIRIAM KAKON3 | 98 ABALONE LN E PONTE VEDRA BEACH, FL 32082 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $59 | $5 | $64 | 0.27% |
| DOROTHY RING3 | 8300 PLAZA GATE LN APT 1184 JACKSONVILLE, FL 32217 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $26 | $1 | $27 | 0.12% |
| JAMES ALLEN CONNER3 | 1292 BLUEBIRD DR SQ DELLROY, OH 44620 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $19 | $25 | 0.11% |
| JOSEPH BADGER3 | 1565 MAIN ST PENINSULA, OH 44264 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6 | $16 | $22 | 0.09% |
| EDWARD FRANCIS KLINGES3 | 10 BLACKBURN LANE HAVERFORD, PA 19041 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3 | $2 | $5 | 0.02% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 185 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF FLORIDA | 159 | $3.3M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 409 | $408K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 409 | $408K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 409 | $408K |
| Short-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 409 | $431K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 409 | $408K |
| Other(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 409 | $431K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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.