| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERV OF COLORADO | 6399 S FIDDLERS GREEN CIR STE 200 GREENWOOD VILLAGE, CO 801114974 | KAISER FOUNDATION HEALTH PLAN INC | $18K | — | $18K | 0.38% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERV OF COLORADO | 6399 S FIDDLERS GREEN CIR STE 200 GREENWOOD VILLAGE, CO 801114974 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 0.55% |
| 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 | $12K | — | $12K | 0.80% |
| 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. | $3K | — | $3K | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL FL 14 ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $9K | $9K | 1.67% |
| 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 | $7K | $24K | 5.48% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $4K | $4K | 1.61% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | 6300 S. SYRACUSE WAY SUITE 700 CENTENNIAL, CO 801117305 | HUMANA INSURANCE COMPANY | $850 | — | $850 | 1.96% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL FL 14 ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $574 | $574 | 1.45% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $996 | $380 | $1K | 5.53% |
| GALLAGHER BENEFIT SERVICES, INC. | 6300 S SYRACUSE WAY SUITE 700 CENTENNIAL, CO 801117305 | HUMANA INSURANCE COMPANY | $250 | — | $250 | 1.86% |
| 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 | — | $119 | $119 | 1.78% |
| GALLAGHER BENEFIT SERVICES, INC. Filed as: GALLAGHER BENEFIT SERVICES INC. | 6300 S. SYRACUSE WAY SUITE 700 CENTENNIAL, CO 801117305 | HUMANA INSURANCE COMPANY | $100 | — | $100 | 2.03% |
| LOCKTON COMPANIES, LLC | 444 W 47TH ST, STE 900 KANSAS CITY, KS 641121906 | FEDERAL INSURANCE COMPANY | $176 | — | $176 | 6.24% |
| GALLAGHER BENEFIT SERVICES, INC.7 Filed as: GALLAGHER BENEFIT SERVICE | 2 PIERCE PL 14TH FL ITASCA, IL 60143 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $108 | $130 | $238 | 8.82% |
| GALLAGHER BENEFIT SERVICES, INC. | 6300 S SYRACUSE WAY, STE 700 CENTENNIAL, CO 801117305 | HUMANA INSURANCE COMPANY | $50 | — | $50 | 1.86% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXPRESS SCRIPTS, INC EIN 43-1420563 NONE | Other fees Service code 99 | — | $4.1M |
| ROCKY MOUNTAIN HOSIPTAL AND MEDICAL EIN 84-0747736 NONE | Contract Administrator; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Float revenue Service code 12 | — | $780K |
| ANTHEM BLUE CROSS LIFE AND HEALTH EIN 95-4331852 NONE | Float revenue; Claims processing; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $50K |
| GALLAGHER BENEFIT SERVICES INC. NONE | Insurance brokerage commissions and fees; Other commissions; Insurance agents and brokers Service code 22 | 1900 WEST LOOP SOUTH SUITE 1600 HOUSTON, TX 77027 | $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 | 3,627 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 350 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 3,977 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | MVP HEALTH CARE | 27 | $228K |
| Dental(2 contracts) | DELTA DENTAL OF COLORADO | 5,100 | $2.1M |
| Vision | VISION SERVICE PLAN | 2,436 | $299K |
| Life insurance(2 contracts) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,573 | $687K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 0 | $3K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 1,918 | $564K |
| Stop-loss / reinsurancereinsurance | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 2,605 | $1.0M |
| Other(6 contracts, 4 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 3,573 | $598K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 5,100 | — |
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.