| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 WEST 20TH STREET GREELY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $3K | $11K | 13.10% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $3K | $3K | 4.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS, LLC | 8205 WEST 20TH STREET GREELY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | $887 | $7K | 11.29% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 WEST 20TH STREET GREELY, CO 80634 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | $0 | $1K | 6.50% |
| PFS INSURANCE GROUP LLC3 | 4848 THOMPSON PARKWAY SUITE 200 JOHNTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $207 | $0 | $207 | 1.09% |
| KIMBER K. KORSGAARD3 | 5233 ARROWHEAD LANE FORT COLLINS, CO 80526 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $842 | $0 | $842 | 11.96% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 WEST 20TH STREET GREELY, CO 80634 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $572 | $0 | $572 | 8.13% |
| DYLAN VALLINO3 | 1230 WALNUT STREET WINDSOR, CO 80550 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $148 | $0 | $148 | 2.10% |
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 | 134 | 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) | 135 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 83 | $64K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 83 | $64K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 218 | $87K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 218 | $87K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 218 | $87K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 218 | $113K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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.