| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 2 PARK PLZ SUITE 440 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.92% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 2 PARK PLZ SUITE 440 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $2K | $2K | 5.65% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 7.96% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $237 | — | $237 | 0.90% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INSURANCE AGENCY | 2 PARK PLZ SUITE 440 IRVINE, CA 92614 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP SUITE 304 MANASSAS, VA 20109 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.67% |
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 | 424 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 26 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 451 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 245 | $147K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 423 | $26K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 424 | $52K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 424 | $27K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 424 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 424 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.