| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 | 1125 17TH STREET, SUITE 400 DENVER, CO 80202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $24K | $24K | 0.47% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $38K | $38K | 7.09% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $99 | $99 | 0.02% |
| AXA ASSISTANCE, USA5 | 122 SOUTH MICHIGAN AVENUE SUITE 1100 CHICAGO, IL 60603 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $0 | $17 | $17 | 0.00% |
| HAYS COMPANIES, INC.3 | PO BOX 1414 MINNEAPOLIS, MN 55480 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $60 | $15K | 4.70% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC | 6200 SOUTH SYRACUSE WAY, SUITE 460 GREENWOOD VILLAGE, CO 80111 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $0 | $15K | 4.68% |
| INS EXCHANGE LLC3 | 5 ROEHM COURT WEST ORANGE, NJ 07052 | METROPOLITAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 1.13% |
| HAYS COMPANIES, INC.3 | 80 SOUTH 8TH STREET, SUITE 700 MINNEAPOLIS, MN 55402 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $2K | $2K | 0.59% |
| SITZMANN MORIS & LAVIS3 Filed as: SITZMANN MORRIS & BOYLE INS AGY LLC | 3697 MOUNT DIABLO BOULEVARD SUITE 100 LAFAYETTE, CA 94549 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $10K | $20K | $30K | 14.38% |
| NATIONAL PLANNING CONSULTANTS INC3 Filed as: NATIONAL PLANNING CONSULTANTS, INC. | 3390 PEACHTREE ROAD NE SUITE 101 ATLANTA, GA 30326 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $8K | $15K | $23K | 10.84% |
| MADISON GROUP, INC.3 | 5299 DTC BOULEVARD, SUITE 1100 GREENWOOD VILLAGE, CO 80111 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $5K | $10K | 4.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF CALIFORNIA, INC. | 3697 MOUNT DIABLO BOULEVARD SUITE 100 LAFAYETTE, CA 94549 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $5K | $6K | 2.90% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL HOLDINGS, INC. | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97209 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $0 | $5K | $5K | 2.51% |
| DONALD EUGENE MORRIS3 | 1850 MOUNT DIABLO BOULEVARD SUITE 430 WALNUT CREEK, CA 94596 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $5K | $0 | $5K | 2.15% |
| GCG FINANCIAL LLC3 Filed as: MORRIS & BOYLE AN ALERA INS. AGENCY | 1820 MOUNT DIABLO BOULEVARD SUITE 430 WALNUT CREEK, CA 94596 | EXCEPTIONAL RISK ADVISORS | $5K | $0 | $5K | 12.14% |
| NATIONAL PLANNING CONSULTANTS INC3 Filed as: NATIONAL PLANNING CONSULTANTS, INC. | 375 NORTHRIDGE ROAD, SUITE 515 ATLANTA, GA 30350 | EXCEPTIONAL RISK ADVISORS | $5K | $0 | $5K | 12.14% |
| M FINANCIAL HOLDINGS INC3 Filed as: M FINANCIAL GROUP | 1125 NW COUCH STREET, SUITE 900 PORTLAND, OR 97290 | EXCEPTIONAL RISK ADVISORS | $647 | $0 | $647 | 1.46% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET KANSAS CITY, MO 64112 | THE PAUL REVERE LIFE INSURANCE COMPANY | $0 | $448 | $448 | 4.09% |
| BENEFIT MANAGEMENT AND DESIGN, INC.3 | 8110 EAST UNION AVENUE, SUITE 700 DENVER, CO 80237 | THE PAUL REVERE LIFE INSURANCE COMPANY | $286 | $0 | $286 | 2.61% |
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 | 533 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 545 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 548 | $5.0M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 935 | $330K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 935 | $324K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 533 | $541K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 533 | $541K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 548 | $5.0M |
| Other(6 contracts, 6 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 935 | $1.2M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 935 | — |
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.