| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICCES | P O BOX 896620 CHARLOTTE, NC 28289 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $9K | — | $9K | 7.82% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: PACIFIC RESOURCES BENEFITS ADV | 12647 ALCOSTA BLVD SUITE 330 SAN RAMON, CA 94583 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.59% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 3.59% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | ATTN HAYS BOSTON 80 S STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $8K | — | $8K | 8.67% |
| MCGRIFF INSURANCE SERVICES INC3 | ATTN EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 5.08% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INCC | ATTN HAYS 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $840 | — | $840 | 0.94% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | ATTN HAYS BOSTON 80 S STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $3K | — | $3K | 8.70% |
| MCGRIFF INSURANCE SERVICES INC3 | ATTN EB COMMISSION P O BOX 896620 CHARLOTTE, NC 28289 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 5.02% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | ATTN HAYS 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | STANDARD INSURANCE COMPANY | $305 | — | $305 | 0.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN DBA | HAYS COMPANIES 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $859 | — | $859 | 5.82% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF SEIBELS AND WILLIAMS INC | 150 SOUTH 5TH STREET SUITE 2855 MINNEAPOLIS, MN 55402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $619 | — | $619 | 4.19% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | 133 FEDERAL STREET 3RD FLOOR BOSTON, MA 02110 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $150 | — | $150 | 1.02% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | HARTFORD LIFE AND ACCIDENT | $58 | — | $58 | 1.55% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 150 SOUTH 5TH STREET SUITE 2855 MINNEAPOLIS, MN 55492 | HARTFORD LIFE AND ACCIDENT | $17 | — | $17 | 0.45% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF FLORIDA INC | 100 RIALTO PLACE SUITE 900 MELBOURNE, FL 32901 | HARTFORD LIFE AND ACCIDENT | — | $6 | $6 | 0.16% |
| MCGRIFF INSURANCE SERVICES INC3 Filed as: MCGRIFF INSURANCE SERVICES LLC | 150 SOUTH 5TH STREET SUITE 2855 MINNEAPOLIS, MN 55402 | NATIONAL UNION FIRE INSURANCE COMPANY OF PITTSBURGH PA | $216 | — | $216 | 15.03% |
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 | 121 | 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) | 121 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 155 | $15K |
| Life insurance | STANDARD INSURANCE COMPANY | 121 | $89K |
| Long-term disability | STANDARD INSURANCE COMPANY | 109 | $33K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 132 | $119K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 155 | — |
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.