| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY ST STE 101 LONGMONT, CO 80501 | DELTA DENTAL OF COLORADO | $8K | — | $8K | 8.34% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY ST STE 101 LONGMONT, CO 80501 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | $2K | $12K | 14.03% |
| LEAVITT GROUP3 Filed as: LEAVITT GROUP AGENCY ASSC, LLC | PO BOX 130 CEDAR CITY, UT 847210135 | PRINCIPAL LIFE INSURANCE COMPANY | — | $380 | $380 | 0.44% |
| EMPLOYEE CHOICE SOLUTIONS3 | 2200 S MAIN STREET SUITE 600 SALT LAKE CITY, UT 84115 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROCKY MOUNTAIN HOSPITAL & MEDICAL EIN 84-0747736 CLAIMS PROCESSOR | Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator; Float revenue; Other services Service code 12 | — | $38K |
| CENTERSTONE INSURANCE FEES PAID5 | Other commissions; Non-monetary compensation; Insurance agents and brokers Service code 22 | 4851 LBJ FREEWAY DALLAS, TX 75244 | $0 |
| GBS COLORADO LLC EIN 81-3387763 SALES AND BASE COMMISSION | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees; Non-monetary compensation Service code 22 | — | $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 | 126 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 126 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 212 | $98K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $86K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $86K |
| Short-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $86K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 235 | $86K |
| Stop-loss / reinsurancereinsurance | ROCKY MOUNTAIN HOPSITAL & MEDICAL SERVICE, INC. | 191 | $180K |
| Other | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 36 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 235 | — |
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.