| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DAWN RENEE MORGAN3 | 6413 DUNMOOR DR PLANO, TX 75093 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $233 | $2K | 7.32% |
| EVAN D BURDEN3 | 7807 E PEAKVIEW AVE 450 CENTENNIEL, CO 80111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $419 | $2K | 6.86% |
| VB ADVISORS LLC3 | 2040 TERRY STREET STE 101 LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 6.47% |
| MAXIMUM BENEFIT SOLUTIONS LLC3 Filed as: MAXIMUM BENEFIT SOLUTIONS | 139 GRANITE PEAK DRIVE BOZEMAN, MT 59718 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $100 | — | $100 | 0.31% |
| FOREVER EMPLOYER LTD3 | 2001 ROSEN DRIVE FORT COLLINS, CO 80528 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $66 | — | $66 | 0.21% |
| VOLUNTARY SOLUTIONS INC3 | 509 SOUTH 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | $34 | $64 | 0.20% |
| JAMES M EANES3 | 1700 E JACKSON ST PENSACOLA, FL 32501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $21 | $6 | $27 | 0.08% |
| D'ARCIPRETE & ASSOCIATES INC3 | 12945 US HIGHWAY 331 MONTGOMERY, AL 36105 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1 | $2 | $3 | 0.01% |
| WAYNE RIMMER3 | 7454 FARMERS RD PENSACOLA, FL 32526 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2 | — | $2 | 0.01% |
| VB ADVISORS LLC3 | 2040 TERRY ST 101 LONGMONT, CO 80501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 9.52% |
| VB ADVISORS LLC3 | 2040 TERRY ST 101 LONGMONT, CO 80501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| VB ADVISORS LLC3 Filed as: VB ADVISORS, LLC | 2040 TERRY ST STE 101 LONGMONT, CO 80501 | VISION SERVICE PLAN | $728 | — | $728 | 7.20% |
| VB ADVISORS LLC3 | 2040 TERRY ST 101 LONGMONT, CO 80501 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $417 | — | $417 | 14.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Claims processing Service code 12 | — | $21K |
| CIGNA | Non-monetary compensation; Other services; Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $0 |
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 | 107 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 79 | $10K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $35K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 107 | $14K |
| Other(3 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 108 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 108 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.