| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC. | 7570 W. 21ST STREET N SUITE 1038-A WICHITA, KS 67205 | BLUE CROSS BLUE SHIELD OF TEXAS, A DVISION OF HEALTH CARE SERVICE CORP | $15K | — | $15K | 1.74% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 7570 W. 21ST STREET N SUITE 1038-A WICHITA, KS 67205 | BLUE CROSS BLUE SHIELD OF TEXAS, A DVISION OF HEALTH CARE SERVICE CORP | $11K | — | $11K | 1.29% |
| HAYS COMPANIES, INC.3 | 80 S ST SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $4K | $554 | $5K | 11.26% |
| HAYS COMPANIES, INC.3 | 80 S ST SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $6K | $636 | $7K | 16.56% |
| HAYS COMPANIES, INC.3 | 80 S ST SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $3K | $575 | $3K | 8.12% |
| HAYS COMPANIES, INC.3 | 80 S ST SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $3K | $548 | $3K | 18.06% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 S ST SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $1K | $182 | $1K | 11.78% |
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 | 196 | 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) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF TEXAS, A DVISION OF HEALTH CARE SERVICE CORP | 115 | $839K |
| Dental | STANDARD INSURANCE COMPANY | 85 | $44K |
| Vision | STANDARD INSURANCE COMPANY | 83 | $10K |
| Life insurance | STANDARD INSURANCE COMPANY | 160 | $18K |
| Short-term disability | STANDARD INSURANCE COMPANY | 74 | $38K |
| Long-term disability | STANDARD INSURANCE COMPANY | 65 | $41K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF TEXAS, A DVISION OF HEALTH CARE SERVICE CORP | 115 | $839K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 196 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 196 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.