| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 2 PARK PLAZA SUITE 440 IRVINE, CA 92614 | CALIFORNIA PHYSICIANS' SERVICE | $74K | — | $74K | 1.95% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | CALIFORNIA PHYSICIANS' SERVICE | $40K | — | $40K | 1.05% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 880 APOLLO STREET SUITE 300 EL SEGUNDO, CA 90245 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $116 | $4K | 3.07% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $384 | $2K | 1.34% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 S 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | — | $1K | $1K | 1.17% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 18201 VON KARMAN AVE SUITE 510 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 10.62% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.19% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP | 18201 VON KARMAN AVE SUITE 510 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 10.16% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 3.37% |
| HAYS COMPANIES, INC.3 Filed as: HAYS OF CALIFORNIA INS SERVICES | 880 APOLLO STREET SUITE 300 EL SEGUNDO, CA 90245 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 8.16% |
| FLEXVISION - MD3 | 15400 CALHOUN DR ROCKVILLE, MD 20855 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $2K | $2K | 4.93% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $547 | — | $547 | 1.70% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 18201 VON KARMAN AVE SUITE 510 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $817 | $2K | 10.48% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $710 | — | $710 | 3.22% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $231 | $149 | $380 | 2.63% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $148 | $46 | $194 | 1.34% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP LLC | 80 SOUTH 8TH STREET SUITE 700 MINNEAPOLIS, MN 55402 | SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION | $377 | $155 | $532 | 4.13% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | SAFEGUARD HEALTH PLANS, INC. A TEXAS CORPORATION | $135 | $42 | $177 | 1.37% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 18201 VON KARMAN AVE SUITE 510 IRVINE, CA 92612 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $682 | $344 | $1K | 9.81% |
| MERCER HEALTH AND BENEFITS, LLC3 | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $364 | — | $364 | 3.48% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 18201 VON KARMAN AVE SUITE 510 IRVINE, CA 92612 | MUTUAL OF OMAHA INSURANCE COMPANY | $205 | — | $205 | 16.04% |
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 | 481 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 488 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 800 | $3.8M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 328 | $148K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 394 | $32K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 481 | $93K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $22K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 128 | $54K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 800 | $3.8M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 481 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 800 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.