| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $24K | $0 | $24K | 4.93% |
| MJ INSURANCE3 | 3900 EAST CAMELBACK ROAD, SUITE 225 PHOENIX, AZ 85018 | AMERICAN FIDELITY ASSURANCE COMPANY | $15K | $0 | $15K | 4.77% |
| CADA INSURANCE SERVICES INC3 Filed as: CADA INSURANCE SERVICES, INC. | 290 SPEER BOULEVARD DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $2K | — | $2K | 0.70% |
| COLORADO AUTO DEALERS ASSOCIATION3 | UNKNOWN DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $0 | $2K | $2K | 0.66% |
| MJ INSURANCE3 | PO BOX 3430 CARMEL, IN 46082 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $3K | $9K | 24.20% |
| MJ INSURANCE3 | 571 MONON BOULEVARD, SUITE 400 CARMEL, IN 46032 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | $0 | $11K | 47.16% |
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 | 146 | 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) | 146 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 60 | $483K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 212 | $24K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 212 | $24K |
| Life insurance(2 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 247 | $357K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 84 | $322K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 84 | $322K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 60 | $483K |
| Other(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 247 | $840K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 247 | — |
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.