| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 806344697 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $34K | — | $34K | 10.67% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | $13K | $15K | 4.76% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | DELTA DENTAL OF COLORADO | $2K | — | $2K | 2.99% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8025 W. 20TH ST GREELEY, CO 806344697 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $846 | $4K | 12.58% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 806344697 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $536 | $3K | 12.07% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 806344697 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $434 | $3K | 12.08% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | EYEMED VISION CARE | $1K | — | $1K | 9.91% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SERVICE PROVIDER | Contract Administrator; Non-monetary compensation; Other services; Direct payment from the plan; Claims processing; Named fiduciary; Participant communication; Float revenue Service code 12 | — | $47K |
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 | 134 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 134 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 152 | $321K |
| Dental | DELTA DENTAL OF COLORADO | 204 | $73K |
| Vision | EYEMED VISION CARE | 191 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 66 | $33K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $26K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 163 | $54K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.