| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE UNDERWRITERS GROUP INC3 | P O BOX 23790 LOUISVILLE, KY 40223 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | $87K | $0 | $87K | 3.12% |
| THE UNDERWRITERS GROUP INC3 | 1700 EASTPOINT PKWY LOUISVILLE, KY 40223 | DELTA DENTAL OF COLORADO | $6K | $0 | $6K | 3.46% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 6143 S WILLOW DR STE 200 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $3K | $0 | $3K | 2.00% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | DELTA DENTAL OF COLORADO | $2K | $0 | $2K | 1.55% |
| THE UNDERWRITERS GROUP INC3 | 1700 EASTPOINT PKWY LOUISVILLE, KY 40223 | STANDARD INSURANCE COMPANY | $3K | $2K | $5K | 5.62% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | STANDARD INSURANCE COMPANY | $553 | $0 | $553 | 0.62% |
| THE UNDERWRITERS GROUP INC3 | 1700 EASTPOINT PKWY LOUISVILLE, KY 40223 | STANDARD INSURANCE COMPANY | $5K | $2K | $6K | 7.28% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | STANDARD INSURANCE COMPANY | $270 | $0 | $270 | 0.31% |
| THE UNDERWRITERS GROUP INC3 | 1700 EASTPOINT PKWY LOUISVILLE, KY 40223 | STANDARD INSURANCE COMPANY | $3K | $1K | $4K | 6.44% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | STANDARD INSURANCE COMPANY | $523 | $0 | $523 | 0.89% |
| THE UNDERWRITERS GROUP INC3 | 1700 EASTPOINT PKWY LOUISVILLE, KY 40223 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.01% |
| HIGGINBOTHAM INS AGENCY INC3 | PO BOX 908 FORT WORTH, TX 761010908 | VISION SERVICE PLAN | $642 | $0 | $642 | 2.50% |
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 | 193 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 194 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE, INC. | 374 | $2.8M |
| Dental | DELTA DENTAL OF COLORADO | 373 | $160K |
| Vision | VISION SERVICE PLAN | 160 | $26K |
| Life insurance | STANDARD INSURANCE COMPANY | 169 | $89K |
| Short-term disability | STANDARD INSURANCE COMPANY | 169 | $59K |
| Long-term disability | STANDARD INSURANCE COMPANY | 169 | $87K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 374 | — |
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.