| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.30% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC. | 509 SOUTH 4TH AVENUE BRIGHTON, CO 80601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $6K | $3K | $9K | 7.21% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $1K | $9K | 7.14% |
| RPM BENEFIT ADVISORS LLC3 Filed as: RPM BENEFIT ADVISORS, LLC | 2997 HYDRA DRIVE LOVELAND, CO 80537 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $2K | $6K | 5.06% |
| SELECTIVE OPTIONS INC3 Filed as: SELECTIVE OPTIONS, INC. | 9720 EAST 151ST PLACE BRIGHTON, CO 80602 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $749 | $3K | 2.68% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SOUTH 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $0 | $3K | 2.48% |
| MJ INSURANCE3 Filed as: SARA CONNICK AND VARIOUS AGENTS | 8547 EAST ARAPAHOE GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $499 | $32 | $531 | 0.42% |
| NATIONAL ENROLLMENT PARTNERS LLC3 Filed as: NATIONAL ENROLLMENT PARTNERS, LLC | 201 CAUGHMEN FARM LANE LEXINGTON, SC 29072 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $450 | $33 | $483 | 0.38% |
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 | 113 | 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) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 141 | $850K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 141 | $850K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 141 | $850K |
| Life insurance | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 169 | $126K |
| Other | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 169 | $126K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.