| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $3K | $0 | $3K | 2.14% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SERVICES, INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $0 | $2K | $2K | 1.50% |
| AFFILIATED BUSINESS SERVICES3 | 8000 EAST PRENTICE AVENUE, SUITE B8 ENGLEWOOD, CO 80111 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $2K | $0 | $2K | 1.22% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | ANTHEM LIFE INSURANCE COMPANY | $987 | $0 | $987 | 2.14% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS. SERVICES, INC. | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | ANTHEM LIFE INSURANCE COMPANY | $0 | $692 | $692 | 1.50% |
| AFFILIATED BUSINESS SERVICES3 | 8000 EAST PRENTICE AVENUE, SUITE B8 ENGLEWOOD, CO 80111 | ANTHEM LIFE INSURANCE COMPANY | $565 | $0 | $565 | 1.22% |
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 | 187 | 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) | 187 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 276 | $131K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 276 | $131K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 187 | $46K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 187 | $46K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 187 | $46K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 187 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 276 | — |
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.