| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC. | 8055 E TUFTS AVE, STE. 1000 DENVER, CO 80237 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $3K | $3K | 0.64% |
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC | 8055 E TUFTS AVE, STE. 1000 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $633 | $4K | 11.72% |
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC. | 8055 E TUFTS AVE, STE. 1000 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $365 | $2K | 11.75% |
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC. | 8055 E TUFTS AVE, STE. 1000 DENVER, CO 80237 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.60% |
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC. | 8055 E TUFTS AVE, STE. 1000 DENVER, CO 80237 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $205 | $2K | 11.45% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 | Contract Administrator; Claims processing; Non-monetary compensation; Participant communication; Other services; Named fiduciary; Direct payment from the plan; Float revenue Service code 12 | — | $31K |
| CIGNA | Participant communication; Named fiduciary; Claims processing; Float revenue; Non-monetary compensation; Contract Administrator; Direct payment from the plan; Other services Service code 12 | — | $56 |
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 | 207 | 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) | 207 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 397 | $419K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 397 | $419K |
| Vision | VISION SERVICE PLAN | 137 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $21K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $37K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 397 | $419K |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 397 | $419K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 206 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 397 | — |
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."
No prospect flags tripped on this filing.