| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS GROUP INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | MEDICA INSURANCE COMPANY | $0 | $3K | $3K | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 3600 AMERICAN BLVD W STE 500 BLOOMINGTON, MN 55431 | MEDICA INSURANCE COMPANY | $0 | $3K | $3K | 0.13% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 GOLF ROAD GBS FINANCE 5TH FL ROLLING MEADOWS, IA 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $954 | $954 | 2.98% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 GOLF ROAD GBS FINANCE 5TH FL ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $876 | $876 | 6.64% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 80 SOUTH 8TH STREET MINNEAPOLIS, MA 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $640 | $0 | $640 | 5.92% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 3600 AMERICAN BLVD WEST #500 BLOOMINGTON, MN 55431 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $348 | $0 | $348 | 3.22% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICE | 2850 GOLF ROAD GBS FINANCE 5TH FL ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $189 | $189 | 3.23% |
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 | 188 | 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) | 188 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MEDICA INSURANCE COMPANY | 320 | $2.6M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 161 | $11K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 187 | $32K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 188 | $13K |
| Other(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 187 | $38K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.