| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN MN MINNEAPOLIS | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | $19K | $0 | $19K | 2.90% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN MN MINNEAPOLIS | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | UNITEDHEALTHCARE INSURANCE COMPANY | $46K | $0 | $46K | 7.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICES INC. | 3390 UNIVERSITY AVENUE, SUITE 300 RIVERSIDE, CA 92501 | UNITEDHEALTHCARE INSURANCE COMPANY | -$5 | $0 | -$5 | -0.00% |
| HAYS COMPANIES, INC.3 | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | UNITEDHEALTHCARE INSURANCE COMPANY | -$89 | $0 | -$89 | -0.01% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $1K | $4K | 9.20% |
| HAYS COMPANIES, INC.3 | 901 MARQUETTE AVENUE, SUITE 180 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $99 | $3K | 7.13% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $3K | $3K | 6.27% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE, INC. | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $266 | $2K | 4.44% |
| HAYS COMPANIES, INC.3 | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $297 | $2K | 3.47% |
| JAMES H. VAN EPPS3 Filed as: JAMES VANEPPS | 10930 CRABAPPLE ROAD, SUITE 206 ROSWELL, GA 30075 | METROPOLITAN LIFE INSURANCE COMPANY | $991 | $0 | $991 | 2.22% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $480 | $480 | 1.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SVCS., INC. | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $396 | $396 | 0.89% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE, INC. | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $76 | $76 | 0.17% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES INC | PO BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $7 | $7 | 0.02% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN GENERAL INSURANCE COMPANY | $160 | $0 | $160 | 6.80% |
| HAYS COMPANIES, INC.3 | 901 MARQUETTE AVENUE, SUITE 1800 MINNEAPOLIS, MN 55402 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $693 | $0 | $693 | 346.50% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $362 | $80 | $442 | 221.00% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 Filed as: BOON CHAPMAN BENEFIT ADMINISTRATOR | PO BOX 9201 AUSTIN, TX 78766 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $0 | $362 | $362 | 181.00% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $0 | $69 | $69 | 34.50% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS SERVICE, INC. | 600 CORPORATE POINTE, SUITE 600 CULVER CITY, CA 90230 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $31 | $0 | $31 | 15.50% |
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 | 109 | 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) | 109 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 258 | $1.5M |
| Dental(3 contracts, 3 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 389 | $258K |
| Vision(2 contracts, 2 carriers) | HAWAII MEDICAL SERVICE ASSOCIATION | 389 | $258K |
| Prescription drug(3 contracts, 3 carriers) | HEALTH PLAN OF NEVADA/SIERRA HEALTH & LIFE | 258 | $1.5M |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 389 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 389 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.