| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $710 | $4K | 8.84% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $533 | $4K | 12.45% |
| MELISSA A KOLL3 Filed as: MELISSA KOLL | 216 CLIMAX DRIVE DILLON, CO 80435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $479 | $3K | 9.26% |
| OPTIO LLC3 | 8547 E ARAPAHOE ROAD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $759 | $3K | 8.62% |
| MICHAEL TERRENCE FLEMING3 Filed as: MICHAEL TERRANCE FLEMING | 4487 CHRISTENSON CIRCLE LITTLETON, CO 80123 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.25% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $607 | $155 | $762 | 2.36% |
| JOHN E LEVINS3 | 3941 HERITAGE VIEW TRAIL WAKE FOREST, NC 27587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $428 | — | $428 | 1.33% |
| STEPHANIE A LEVINS3 | 3941 HERITAGE VIEW TRAIL WAKE FOREST, NC 27587 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $141 | — | $141 | 0.44% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS INC. | 195 TELLURIDE STREET BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $22 | $17 | $39 | 0.12% |
| JUDITH I VIDAL3 Filed as: JUDITH A HEISERMAN | 7220 E EUCLID DRIVE CENTENNIAL, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13 | — | $13 | 0.04% |
| JAMES D THRESHER3 | 1316 E NIGHTINGALE LANE GILBERT, AZ 85298 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | $1 | $3 | 0.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $208 | $2K | 13.10% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $200 | $34 | $234 | 10.68% |
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 | 312 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 8 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 320 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 203 | $163K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 203 | $163K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 312 | $12K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 106 | $43K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 105 | $34K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 312 | $34K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 312 | — |
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.