| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS BENEFIT GROUP, LLC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $2K | $775 | $3K | 8.46% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH ST MINNEAPOLIS, MN 55402 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $3K | $517 | $3K | 13.09% |
| OSBORNE PROPERTIES LTD PTNRSHP3 Filed as: OSBORNE PROPERTIES LLP | 420 GATEWAY BLVD BURNSVILLE, MN 55337 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $17 | — | $17 | 0.34% |
| OSBORNE PROPERTIES LTD PTNRSHP3 Filed as: OSBORNE PROPERTIES LLP | 420 GATEWAY BLVD BURNSVILLE, MN 55337 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.68% |
| ELSIE M POLT3 | 901 MARQUETTE AVE SUITE 1500 MINNEAPOLIS, MN 55402 | AFLAC | $44 | — | $44 | 4.55% |
| MATTHEW R LORENZ3 | 1021 PROSPECT POINTE RD JORDAN, MN 55342 | AFLAC | $22 | — | $22 | 2.28% |
| DARIN D PAVLISH3 | 7760 FRANCE AVE S 1162 EDINA, MN 55435 | AFLAC | $12 | — | $12 | 1.24% |
| HAROLD D SCHWALM3 | 6413 BROOK LN SAVAGE, MN 55378 | AFLAC | $11 | — | $11 | 1.14% |
| ELISE M POLT3 | 201 W BURNSVILLE PKWY SUITE 116 BURNSVILLE, MN 55337 | AFLAC | $9 | — | $9 | 0.93% |
| JEFFREY PAUL GRIFFIN3 Filed as: JEFFREY ALLEN FOWLER | 8613 E VIA DE SERENO SCOTTSDALE, AZ 85258 | AFLAC | $8 | — | $8 | 0.83% |
| JOHN PAUL THOMPSON SR3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $4 | — | $4 | 0.41% |
| JESSE A REISCH3 | 1505 S MONTICELLO AVE SIOUX FALLS, SD 57106 | AFLAC | $3 | — | $3 | 0.31% |
| BARRY CAMPBELL3 | 2798 COUNTY ROAD 80 ALGER, OH 45812 | AFLAC | $2 | — | $2 | 0.21% |
| JEFFREY M HANSEN3 | 1895 52ND ST SW PEQUOT LAKES, MN 56472 | AFLAC | $1 | — | $1 | 0.10% |
| MICHELLE RAE MAGUIRE3 | 7825 WASHINGTON AVE S SUITE 425 MINNEAPOLIS, MN 55439 | AFLAC | $1 | — | $1 | 0.10% |
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 | 361 | 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) | 366 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 32 | $5K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 437 | $35K |
| Life insurance | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 366 | $38K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 362 | $25K |
| Other(4 contracts, 4 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 366 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 437 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.