| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $46K | — | $46K | 12.19% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $24 | $24 | 0.01% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $2K | $4K | 17.32% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST STE A GREELEY, CO 80634 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 10.02% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC | 9725 E. HAMPDEN AVE 400 DENVER, CO 80231 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 5.03% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | $1K | $3K | 17.90% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $676 | $676 | 4.00% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $997 | $2K | 17.69% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $519 | $519 | 4.00% |
| INS EXCHANGE LLC3 | 5 ROEHM CT WEST ORANGE, NJ 070526606 | METROPOLITAN LIFE INSURANCE COMPANY | $375 | $375 | $750 | 8.94% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | METROPOLITAN LIFE INSURANCE COMPANY | $749 | — | $749 | 8.93% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC | 6200 S SYRACUSE WAY STE 460 C/O CARRARA PLACE GREENWOOD VILLAGE, CO 80231 | METROPOLITAN LIFE INSURANCE COMPANY | $300 | $86 | $386 | 4.60% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS, LLC | 8205 W 20TH ST GREELEY, CO 80634 | BETA HEALTH | $1K | — | $1K | 12.84% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI-MILLER BENEFITS, LLC | 8205 W 20TH ST GREELEY, CO 80634 | BETA HEALTH | $116 | — | $116 | 1.40% |
| PINNACLE BROKERS3 Filed as: PINNACLE FINL SERVICES LLC | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $287 | — | $287 | 3.64% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI-MILLER BNFTS LLC | 8205 W 20TH ST GREELEY, CO 80634 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $214 | — | $214 | 2.71% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMPANION LIFE INSURANCE COMPANY | $650 | — | $650 | 10.08% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC | 9725 E. HAMPDEN AVE 400 DENVER, CO 80231 | COMPANION LIFE INSURANCE COMPANY | $328 | — | $328 | 5.09% |
| KIMBER K. KORSGAARD4 | UNIT 104 1112 OAKRIDGE DR. FT. COLLINS, CO 80525 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $527 | — | $527 | 11.06% |
| DYLAN VALLINO4 | 1230 WALNUT ST WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $500 | — | $500 | 10.50% |
| SHIRAZI-MILLER BENEFITS LLC4 Filed as: SHIRAZI BENEFITS LLC | OFC 8205 W 20TH ST GREELEY, CO 80634 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $204 | — | $204 | 4.28% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMBINED INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 69.76% |
| KIMBER K. KORSGAARD4 | UNIT 104 1112 OAKRIDGE DR FT. COLLINS, CO 80525 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $172 | — | $172 | 8.94% |
| DYLAN VALLINO4 | 1230 WALNUT ST WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $154 | — | $154 | 8.00% |
| SHIRAZI-MILLER BENEFITS LLC4 Filed as: SHIRAZI BENEFITS LLC | OFC 8205 W 20TH ST FT. COLLINS, CO 80634 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $74 | — | $74 | 3.85% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMBINED INSURANCE COMPANY OF AMERICA | $743 | — | $743 | 70.03% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $73 | $53 | $126 | 17.31% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $29 | $29 | 3.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSOR | Contract Administrator; Named fiduciary; Participant communication; Direct payment from the plan; Other services; Float revenue; Claims processing; Non-monetary compensation Service code 12 | — | $128K |
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 | 130 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 1 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 166 | $375K |
| Dental(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 40 | $35K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 192 | $8K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 214 | $13K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $17K |
| Long-term disability(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 134 | $29K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 166 | $375K |
| Other(5 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 214 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.