| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 WEST 20TH STREET GREELEY, CO 80631 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $2K | $10K | 10.95% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $4K | $4K | 3.95% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 WEST 20TH STREET, SUITE A GREELEY, CO 80631 | COMPANION LIFE INSURANCE COMPANY | $6K | $14 | $6K | 10.58% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC. | 6200 SOUTH SYRACUSE WAY, SUITE 460 GREENWOOD VILLAGE, CO 80111 | COMPANION LIFE INSURANCE COMPANY | $3K | $7 | $3K | 5.29% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 WEST 20TH STREET GREELEY, CO 80631 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.41% |
| PINNACLE BROKERS3 Filed as: PINNACLE FINANCIAL SERVICES LLC | 4848 THOMPSON PARKWAY, SUITE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $310 | $0 | $310 | 1.48% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 WEST 20TH STREET, SUITE A GREELEY, CO 80631 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | $0 | $1K | 10.14% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC. | 6200 SOUTH SYRACUSE WAY, SUITE 460 GREENWOOD VILLAGE, CO 80111 | METROPOLITAN LIFE INSURANCE COMPANY | $502 | $49 | $551 | 4.46% |
| INS EXCHANGE LLC3 | 5 ROEHM COURT WEST ORANGE, NJ 07052 | METROPOLITAN LIFE INSURANCE COMPANY | $376 | $43 | $419 | 3.39% |
| KIMBER K. KORSGAARD3 | 5233 ARROWHEAD LANE FORT COLLINS, CO 80526 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $1K | $0 | $1K | 16.96% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 WEST 20TH STREET GREELEY, CO 80634 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $818 | $0 | $818 | 11.95% |
| DYLAN VALLINO3 | 1230 WALNUT STREET WINDSUR, CO 80550 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $108 | $0 | $108 | 1.58% |
| KIMBER K. KORSGAARD4 Filed as: KIMBER K KORSGAARD | 5233 ARROWHEAD LANE FORT COLLINS, CO 80526 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $287 | $0 | $287 | 15.36% |
| BENEFITS LLC SHIRAZI4 | 8205 WEST 20TH STREET GREELEY, CO 80634 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $191 | $0 | $191 | 10.22% |
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 | 104 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INSURANCE COMPANY | 78 | $56K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 244 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 104 | $95K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 104 | $95K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 104 | $95K |
| Other(4 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 104 | $124K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 244 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.