| 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 AND AFFILIATES | $16K | — | $16K | 9.82% |
| GROUP BENEFIT SERVICES INC3 Filed as: GROUP BENEFIT SERVICES LLC | 8055 E TUFTS AVE, STE 1000 DENVER, CO 80237 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $31 | — | $31 | 0.02% |
| JEFFREY P PRICE3 | 3864 S QUINCE ST DENVER, CO 80237 | AFLAC | $5K | — | $5K | 10.27% |
| MOODY INSURANCE AGENCY3 Filed as: MOODY INS AGENCY INC | 8055 E TUFTS AVE STE 1000 DENVER, CO 80237 | AFLAC | $3K | — | $3K | 5.63% |
| KRISTA K PRICE3 | 3864 S QUINCE ST DENVER, CO 80237 | AFLAC | $2K | — | $2K | 3.58% |
| NICOLETTE RAI POWELL3 | 6246 RED CANYON DR #C LITTLETON, CO 80130 | AFLAC | $977 | — | $977 | 2.08% |
| NANCY LAPHAM3 Filed as: NANCY L HARMON | 3925 S QUATAR ST AURORA, CO 80018 | AFLAC | $909 | — | $909 | 1.93% |
| NANCY LAPHAM3 Filed as: NANCY L HARMON | 11747 S SUN TEA WAY SOUTH JORDAN, UT 84009 | AFLAC | $832 | — | $832 | 1.77% |
| OLIVIA MARIE MURRAY3 | 6246 RED CANYON DR APT C HIGHLANDS RANCH, CO 80130 | AFLAC | $293 | — | $293 | 0.62% |
| CHERIE L VAUGHAN3 | 8330 E QUINCY AVE APT A 208 DENVER, CO 80237 | AFLAC | $257 | — | $257 | 0.55% |
| SHERIE GAUNT3 | 3982 S. ODESSA ST AURORA, CO 80013 | AFLAC | $177 | — | $177 | 0.38% |
| ROXANE KARTLER3 | 8083 S JAY DR LITTLETON, CO 80128 | AFLAC | $126 | — | $126 | 0.27% |
| BERNADETTE IRENE RUSSO3 | 20848 PARLIAMENT COURT PARKER, CO 80138 | AFLAC | $65 | $11 | $76 | 0.16% |
| ZENAT SHARIFF BELKIN3 | 9034 E EASTER PL STE202 CENTENNIAL, CO 80112 | AFLAC | $14 | $2 | $16 | 0.03% |
| REGINA K SANTANGELO3 | 6892 S WEBSTER WAY LITTLETON, CO 80128 | AFLAC | $12 | $2 | $14 | 0.03% |
| HEALTHCARE CONNECTIONS INC3 | PO BOX 9 PARKER, CO 80134 | AFLAC | $11 | — | $11 | 0.02% |
| BRUCE A BALLENGER3 | PO BOX 62385 COLORADO SPRINGS, CO 80962 | AFLAC | $7 | — | $7 | 0.01% |
| JENNIFER L FREEMAN3 | 4879 STREAMBED TRL PARKER, CO 80134 | AFLAC | $6 | — | $6 | 0.01% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SVCS INC | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | AFLAC | $5 | — | $5 | 0.01% |
| JEFFREY P PRICE3 | 3864 S. QUINCE STREET DENVER, CO 80237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 13.80% |
| KRISTA K PRICE3 | 3864 S. QUINCE ST DENVER, CO 80237 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 4.65% |
| NANCY LAPHAM3 Filed as: NANCY L HARMON | 3925 S QUATAR ST AURORA, CO 80018 | CONTINENTAL AMERICAN INSURANCE COMPANY | $833 | — | $833 | 3.14% |
| MISTY M KRUG3 | 1686 CHRISTENSEN RD MOUNTAIN HOME, AZ 72653 | CONTINENTAL AMERICAN INSURANCE COMPANY | $269 | — | $269 | 1.01% |
| MICHAEL G SORENSON3 | 3405 E 143RD AVE THORNTON, CT 80602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $156 | — | $156 | 0.59% |
| OLIVIA M MURRAY3 | 784 GATES MILLS DRIVE UNIT 302 FORT MILL, SC 29708 | CONTINENTAL AMERICAN INSURANCE COMPANY | $118 | — | $118 | 0.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE COMPA EIN 59-1031071 PROVIDES CLAIMS ADMIN | Participant communication; Named fiduciary; Non-monetary compensation; Direct payment from the plan; Float revenue; Other services; Claims processing; Contract Administrator Service code 12 | — | $444K |
| MOODY INSURANCE AGENCY BROKER | Consulting (general) Service code 16 | 8055 E TUFTS AVE, STE 1000 DENVER, CO 80237 | $90K |
| SUN LIFE ASSURANCE COMPANY OF CANAD EIN 38-1082080 FMLA ADMIN FEE | Contract Administrator Service code 13 | — | $4K |
| CIGNA HEALTH & LIFE INSURANCE COMP | Participant communication; Named fiduciary; Direct payment from the plan; Other services; Non-monetary compensation; Float revenue; Claims processing; Contract Administrator Service code 12 | — | $0 |
| MOODY INSURANCE AGENCY INC CONSULTING | Consulting (general) Service code 16 | 8055 E TUFTS AVE, STE 1000 DENVER, CO 80237 | $0 |
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 | 307 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 312 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 289 | $161K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 289 | $161K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 448 | $20K |
| Short-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 448 | $47K |
| Long-term disability(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 448 | $47K |
| Other(3 contracts, 3 carriers) | AFLAC | 448 | $94K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 448 | — |
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.