| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC. Filed as: IMA INC | 1705 17TH STREET SUITE 100 DENVER, CO 80202 | BERKLEY LIFE AND HEALTH INSURANCE CO | — | $19K | $19K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| UNITED HEALTHCARE SERVICES, INC. EIN 41-1289245 CLAIMS PROCESSOR | Other services; Claims processing Service code 12 | 22561 NETWORK PLACE CHICAGO, IL 60673 | $561K |
| DELTA DENTAL OF COLORADO EIN 84-0568337 NONE | Contract Administrator Service code 13 | PO BOX 173803 DENVER, CO 80217 | $37K |
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 | 872 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 13 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 885 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 694 | $102K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 941 | $229K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 942 | $140K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 942 | $191K |
| Stop-loss / reinsurancereinsurance | BERKLEY LIFE AND HEALTH INSURANCE CO | 789 | $642K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 940 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 942 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.