| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | AETNA LIFE INSURANCE COMPANY | $14K | — | $14K | 0.82% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $309 | $4K | 10.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT A MARSH & MCLENNAN AGCY. | 8144 WALNUT HILL LN., STE. 1600 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $291 | $291 | 0.79% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH. ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $250 | $5K | 15.87% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT A MARSH & MCLENNAN AGCY. | 8144 WALNUT HILL LN., STE. 1600 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $240 | $240 | 0.83% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH. ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $162 | $3K | 15.86% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT A MARSH & MCLENNAN AGCY. | 8144 WALNUT HILL LN., STE. 1600 DALLAS, TX 75231 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $154 | $154 | 0.81% |
| MC & H AGENCY INC3 Filed as: MC&H AGENCY INC. | 8144 WALNUT LN., 16TH FL. DALLAS, TX 752314388 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $519 | $44 | $563 | 10.84% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MHBT A MARSH & MCLENNAN AGCY. | 8144 WALNUT HILL LN., STE. 1600 DALLAS, TX 75024 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $43 | $43 | 0.83% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $113 | — | $113 | 15.07% |
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 | 211 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 211 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 317 | $1.7M |
| Dental | AETNA LIFE INSURANCE COMPANY | 317 | $1.7M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 322 | $16K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 123 | $37K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 97 | $19K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 211 | $29K |
| Prescription drug | AETNA LIFE INSURANCE COMPANY | 317 | $1.7M |
| Other(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 211 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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."
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.