| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES (CO) INC | 6399 S FIDDLERS GREEN CIR STE 200 GREENWOOD VILLAGE, CO 801114974 | KAISER FOUNDATION HEALTH PLAN INC | $30K | — | $30K | 0.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 1900 WEST LOOP SOUTH, SUITE 1600 HOUSTON, TX 77027 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $19K | — | $19K | 0.42% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES (CO) INC | 6399 S FIDDLERS GREEN CIR STE 200 GREENWOOD VILLAGE, CO 801114974 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 0.51% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 6399 S FIDDLERS GREEN CIR SUITE 200 GREENWOOD VILLAGE, CO 80111 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $19K | — | $19K | 1.76% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $7K | $7K | 1.17% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $18K | $5K | $23K | 5.12% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $6K | $6K | 2.11% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $856 | $856 | 2.17% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $306 | $1K | 5.18% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA | — | MVP HEALTH CARE | $254 | — | $254 | 1.74% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS OF PENNSYLVANIA | — | MVP HEALTH CARE | $35 | — | $35 | 0.25% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $360 | $114 | $474 | 5.27% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | CIGNA LIFE INSURANCE CO. OF NEW YORK | — | $6 | $6 | 0.09% |
| LOCKTON COMPANIES, LLC Filed as: LOCKTON COMPANIES LLC (DENVER) | 444 W 47TH ST, STE 900 KANSAS CITY, MO 641121906 | FEDERAL INSURANCE COMPANY | $155 | — | $155 | 5.50% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $30 | $13 | $43 | 5.80% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC EIN 43-1420563 NONE | Other fees Service code 99 | — | $4.1M |
| ROCKY MOUNTAIN HOSPITAL AND MEDICAL EIN 84-0747736 NONE | Other services; Contract Administrator; Claims processing; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | — | $1.1M |
| GALLAGHER BENEFIT SERVICES INC. NONE | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 6399 S. FIDDLER'S GREEN CIR STE 200 ENGLEWOOD, CO 80111 | $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 | 3,425 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 40 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 3,465 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | MVP HEALTH CARE | 26 | $335K |
| Dental(2 contracts) | DELTA DENTAL OF COLORADO | 4,818 | $2.1M |
| Vision | VISION SERVICE PLAN | 2,267 | $324K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,593 | $726K |
| Long-term disability(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,668 | $638K |
| Stop-loss / reinsurancereinsurance | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 5,598 | $4.5M |
| Other(7 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,277 | $618K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,598 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.