| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY INC. | 155 INVERNESS DRIVE WEST ENGLEWOOD, CO 80112 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $43K | $5K | $48K | 4.09% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR WEST ENGLEWOOD, CO 80112 | STARMOUNT LIFE INSURANCE COMPANY | $6K | $1K | $7K | 11.79% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR. WEST ENGLEWOOD, CO 80112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $720 | $401 | $1K | 5.11% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR WEST ENGLEWOOD, CO 80112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $233 | $3K | 20.32% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR WEST ENGLEWOOD, CO 80112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $168 | $2K | 18.21% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR. WEST ENGLEWOOD, CO 80112 | UNUM INSURANCE COMPANY | $311 | $125 | $436 | 6.38% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR. WEST ENGLEWOOD, CO 80112 | UNUM INSURANCE COMPANY | $584 | $116 | $700 | 11.01% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DR WEST ENGLEWOOD, CO 80112 | UNUM INSURANCE COMPANY | $393 | $66 | $459 | 13.08% |
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 | 206 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | 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) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 186 | $1.2M |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 133 | $58K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 133 | $58K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $35K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $22K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 28 | $9K |
| Other(5 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 206 | $51K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.