| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PFS INSURANCE GROUP LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $40K | — | $40K | 12.59% |
| CENTERSTONE INSURANCE AND FINANCIAL Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $13K | $13K | 4.21% |
| SHIRAZI-MILLER BENEFITS LLC Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 806344697 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $3K | — | $3K | 1.10% |
| PINNACLE BROKERS Filed as: PINNACLE FINL SERVICES LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $14K | $6K | $20K | 17.70% |
| PFS INSURANCE GROUP LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 10.25% |
| PINNACLE BROKERS Filed as: PINNACLE FINL SERVICES LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $589 | — | $589 | 9.87% |
| DYLAN VALLINO4 | 1230 WALNUT ST WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 35.43% |
| KIMBER K. KORSGAARD4 | 1114 OAKRIDGE DR UNIT 104 FORT COLLINS, CO 80525 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $214 | — | $214 | 4.62% |
| SHIRAZI-MILLER BENEFITS LLC4 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $7 | — | $7 | 0.15% |
| DYLAN VALLINO4 | 1230 WALNUT ST WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $291 | — | $291 | 17.35% |
| KIMBER K. KORSGAARD4 | 1112 OAKRIDGE DR UNIT 104 FORT COLLINS, CO 80525 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $170 | — | $170 | 10.14% |
| SHIRAZI-MILLER BENEFITS LLC4 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $7 | — | $7 | 0.42% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSOR | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | — | $32K |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 145 | $334K |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $115K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $115K |
| Life insurance | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $115K |
| Short-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $115K |
| Long-term disability | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $115K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 145 | $314K |
| Other(3 contracts, 2 carriers) | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 116 | $121K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 145 | — |
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.