| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DRIVE W ENGLEWOOD, CO 80112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $8K | $66K | $74K | 1.71% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 SUITE 1200 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | $55K | $62K | 1.43% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY, INC. | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CA 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | — | $9K | 8.02% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- | MOUNTAIN CENTRAL PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 6.98% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY, INC. | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CA 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $8K | — | $8K | 7.89% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- | MOUNTAIN CENTRAL PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | — | $7K | 7.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- | MOUNTAIN CENTRAL PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 7.35% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY, INC. | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CA 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 4.11% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC - | GREENWOOD V PO BOX 62817 VIRGINIA BEACH, VA 23466 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $3K | — | $3K | 5.60% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | D/B/A CCIG 155 INVERNESS DRIVE WEST ENGLEWOOD, CA 80112 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 4.40% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY, INC. | 5660 GREENWOOD PLAZA BLVD STE 500 GREENWOOD VILLAGE, CA 80111 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $894 | — | $894 | 2.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES LLC- | MOUNTAIN CENTRAL PO BOX 62187 VIRGINIA BEACH, VA 23466 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $779 | — | $779 | 2.33% |
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 | 638 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 643 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 838 | $4.3M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 838 | $4.3M |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 910 | $54K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 638 | $94K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 371 | $102K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 315 | $107K |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 638 | $303K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 910 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.