| 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 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $12K | $12K | 1.98% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | AETNA LIFE INSURANCE COMPANY | — | $15K | $15K | 3.04% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH ST. HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $58K | $9K | $67K | 19.22% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $25K | $397 | $25K | 7.22% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS INC. | 897 12TH ST. HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $63K | $10K | $73K | 32.38% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $27K | $10 | $27K | 11.93% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST., STE. 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $2K | $2K | 1.98% |
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 | 2,333 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 2,341 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | HEALTH CARE SERVICE CORPORATION | 3,762 | $998K |
| Vision | VISION SERVICE PLAN | 1,587 | $177K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,333 | $921K |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 1,742 | $497K |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 1,742 | $497K |
| Other(4 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 2,333 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,762 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.