| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $54K | — | $54K | 5.26% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 S. 8TH STREET MINNEAPOLIS, MN 55402 | AMERICAN GENERAL LIFE INSURANCE COMPANY | $7K | — | $7K | 10.00% |
| JOY E GUNDERSON3 | — | AFLAC | $2K | $115 | $2K | 6.92% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | — | AFLAC | $2K | — | $2K | 6.05% |
| G SCOTT COOKE3 | — | AFLAC | $2K | $92 | $2K | 5.57% |
| OLIVIA A. COTE3 Filed as: OLIVIA A COTE | — | AFLAC | $1K | $152 | $2K | 4.45% |
| JAN C. CARROLL3 Filed as: JAN C CARROLL | — | AFLAC | $362 | — | $362 | 1.07% |
| CHRISTOPHER L. TANG3 Filed as: CHRISTOPHER L TANG | — | AFLAC | $159 | — | $159 | 0.47% |
| BARRY MCPHERSON INC3 | — | AFLAC | $100 | $46 | $146 | 0.43% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON AND COMPANY | — | AFLAC | $135 | — | $135 | 0.40% |
| PAUL B KIRTON JR3 | — | AFLAC | $130 | — | $130 | 0.38% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF CALIFORNIA INC. | — | AFLAC | $60 | — | $60 | 0.18% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN ALIHAJIMOMEN | — | AFLAC | $43 | — | $43 | 0.13% |
| STRATEGIC LIFE INSURANCE3 Filed as: STRATEGIC LIFE INS SERVICES INC | — | AFLAC | $40 | — | $40 | 0.12% |
| SCOTT W BLACKSHEAR3 | — | AFLAC | $36 | — | $36 | 0.11% |
| PATRICIA ANN BOSCH3 | — | AFLAC | $31 | — | $31 | 0.09% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: DANIEL T ADAMSON | — | AFLAC | $21 | — | $21 | 0.06% |
| REBECCA ORTIZ3 | — | AFLAC | $16 | — | $16 | 0.05% |
| NICHOLAS E VIGIL3 Filed as: NICHOLAS R D'ERRICO | — | AFLAC | $16 | — | $16 | 0.05% |
| ROXANNE C. BICKHAM3 Filed as: ROXANNE C BICKHAM | — | AFLAC | $13 | — | $13 | 0.04% |
| KEVIN J MARKEL3 | — | AFLAC | $10 | — | $10 | 0.03% |
| DAVID SMITH3 Filed as: DAVID MATTHEW SMITH | — | AFLAC | $10 | — | $10 | 0.03% |
| CHUCK TONDA3 Filed as: CHUCK M CHAN | — | AFLAC | $5 | — | $5 | 0.01% |
| RONALD I MARTINDALE3 | — | AFLAC | $4 | — | $4 | 0.01% |
| TERRANCE M LUCZAJ3 | — | AFLAC | $2 | — | $2 | 0.01% |
| TERRANCE M LUCZAJ3 | — | AFLAC | $2 | — | $2 | 0.01% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC | 80 S. 8TH STREET MINNEAPOLIS, MN 55402 | EYEMED VISION CARE | $1K | — | $1K | 9.95% |
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 | 142 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 142 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 104 | $1.0M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 104 | $1.0M |
| Vision | EYEMED VISION CARE | 157 | $11K |
| Life insurance | AMERICAN GENERAL LIFE INSURANCE COMPANY | 142 | $72K |
| Short-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 142 | $72K |
| Long-term disability | AMERICAN GENERAL LIFE INSURANCE COMPANY | 142 | $72K |
| Other(2 contracts, 2 carriers) | AMERICAN GENERAL LIFE INSURANCE COMPANY | 142 | $106K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.