| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $85K | — | $85K | 14.87% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $11K | — | $11K | 11.70% |
| CERIDIAN HCM INC3 Filed as: CERIDIAN HCM INC. | PO BOX 772830 CHICAGO, IL 60677 | STANDARD INSURANCE COMPANY | — | $3K | $3K | 3.50% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $10K | — | $10K | 12.01% |
| CERIDIAN HCM INC3 Filed as: CERIDIAN HCM INC. | PO BOX 772830 NEWTON, MA 60677 | STANDARD INSURANCE COMPANY | — | $3K | $3K | 3.50% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $16K | — | $16K | 25.31% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC. | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 2.98% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | STANDARD INSURANCE COMPANY | $5K | — | $5K | 11.70% |
| CERIDIAN HCM INC3 Filed as: CERIDIAN HCM INC. | PO BOX 772830 CHICAGO, IL 60677 | STANDARD INSURANCE COMPANY | — | $1K | $1K | 3.50% |
| HILB GROUP OF NEW ENGLAND3 | 2000 CHAPEL VIEW BLVD., STE. 240 CRANSTON, RI 02920 | VISION SERVICE PLAN | $2K | — | $2K | 4.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROCKY MOUNTAIN HOSPITAL & MED. SVCS EIN 84-0747736 THIRD PARTY ADMINISTRATO | Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $316K |
| DELTA DENTAL OF COLORADO EIN 83-4416613 BENEFIT ADMINISTRATOR | Contract Administrator; Claims processing Service code 12 | — | $26K |
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 | 311 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 314 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 531 | $569K |
| Vision | VISION SERVICE PLAN | 213 | $38K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 311 | $144K |
| Short-term disability | STANDARD INSURANCE COMPANY | 311 | $43K |
| Long-term disability | STANDARD INSURANCE COMPANY | 311 | $98K |
| Stop-loss / reinsurancereinsurance | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 531 | $569K |
| Other(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 311 | $144K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 531 | — |
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.