| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARK F BAILEY3 Filed as: MARK FRANKLIN BAILEY | 1200 S PLANTATION ISLAND DRIVE ST AUGUSTINE, FL 32080 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $79K | — | $79K | 2.51% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 NORTH MAYFAIR RD MILWAUKEE, WI 53226 | BLUE CROSS BLUE SHIELD OF ILLINOIS | $58K | — | $58K | 1.82% |
| MFB FINANCIAL INC3 | 1200 S PLANTATION ISLAND DRIVE ST AUGUSTINE, FL 32080 | DEARBORN LIFE INSURANCE COMPANY | $14K | — | $14K | 8.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | DEARBORN LIFE INSURANCE COMPANY | $10K | — | $10K | 5.86% |
| MFB FINANCIAL INC3 | 1200 S PLANTATION ISLAND DRIVE ST AUGUSTINE, FL 32080 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $312 | $3K | 37.22% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $19 | $2 | $21 | 0.23% |
| MFB FINANCIAL INC3 | 1200 S PLANTATION ISLAND DRIVE ST AUGUSTINE, FL 32080 | UNUM INSURANCE COMPANY | $988 | $49 | $1K | 11.53% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 1200 NORTH MAYFAIR RD MILWAUKEE, WI 53226 | UNUM INSURANCE COMPANY | $361 | $48 | $409 | 4.55% |
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 | 791 | 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) | 791 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ILLINOIS | 418 | $3.2M |
| Dental | BLUE CROSS BLUE SHIELD OF ILLINOIS | 418 | $3.2M |
| Vision | DEARBORN LIFE INSURANCE COMPANY | 791 | $177K |
| Life insurance | DEARBORN LIFE INSURANCE COMPANY | 791 | $177K |
| Short-term disability | DEARBORN LIFE INSURANCE COMPANY | 791 | $177K |
| Long-term disability | DEARBORN LIFE INSURANCE COMPANY | 791 | $177K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF ILLINOIS | 418 | $3.2M |
| Other(3 contracts, 3 carriers) | DEARBORN LIFE INSURANCE COMPANY | 791 | $195K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 791 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.