| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX #28852 NEW YORK, NY 10087 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $75K | $8K | $83K | 12.41% |
| WILLIS TOWERS WATSON US LLC3 | COMMISSION LOCKBOX 28852 NEW YORK, NY 10087 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $9K | $4K | $13K | 2.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $0 | $4K | $4K | 0.87% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX #28852 NEW YORK, NY 10087 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $8K | $3K | $12K | 2.82% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF ARIZONA INC | 16220 N SCOTTSDALE RD STE 600 SCOTTSDALE, AZ 85254 | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | $0 | $4K | $4K | 0.86% |
| MJ INSURANCE3 Filed as: VARIOUS AGENTS* | CARE OF CONTINENTAL AMERICAN P.O. BOX 427 COLUMBIA, SC 29202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31K | — | $31K | 18.03% |
| WILLIS TOWERS WATSON US LLC3 | LOCKBOX #28852 PO BOX #28852 NEW YORK, NY 10087 | METLIFE LEGAL PLANS | $887 | $140 | $1K | 11.38% |
| USI INSURANCE SERVICES LLC3 Filed as: USI COLORADO LLC | PO BOX 7050 ENGLEWOOD, CO 80155 | METLIFE LEGAL PLANS | $0 | $10 | $10 | 0.11% |
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 | 1,946 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 76 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 2,022 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 3,897 | $612K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,930 | $670K |
| Short-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,700 | $417K |
| Long-term disability | LINCOLN LIFE ASSURANCE COMPANY OF BOSTON | 1,700 | $472K |
| Stop-loss / reinsurancereinsurance | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 3,897 | $612K |
| Other(4 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 3,897 | $1.5M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,897 | — |
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.