| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $3K | $3K | 2.25% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 2.13% |
| BOWLES ASSOC INC3 Filed as: BOWLES ASSOC INC. | P O BOX 700 FORK UNION, VA 23055 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 6.69% |
| JAMES E. PERKINS3 | 2205 LONG DRIVE ROCKVILLE, VA 23146 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 5.26% |
| TRIBBLE INS AGENCY, INC.3 | 10366 LEADBETTER ROAD ASHLAND, VA 23005 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 5.13% |
| ROSCOE J. DOUGLAS3 | 3783 VINEVILLE AVE MACON, GA 31204 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $37 | — | $37 | 0.13% |
| DEMIAN INS AGENCY INC3 | 12123 MAGNOLIA BLVD NORTH HOLLYWOOD, CA 91607 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $6 | — | $6 | 0.02% |
| PERRY INS AGCY INC3 | 8661 STAPLES MILL RD RICHMOND, VA 23228 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5 | — | $5 | 0.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $276 | $276 | 2.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $132 | $132 | 1.40% |
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 | 1,456 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,467 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AMERICAN HERITAGE LIFE INSURANCE COMPANY | 199 | $28K |
| Dental | DELTA DENTAL OF COLORADO | 2,034 | $637K |
| Vision | VISION SERVICE PLAN | 884 | $154K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,456 | $113K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 653 | $75K |
| Other(3 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,456 | $136K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,034 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.