| 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 | $31K | — | $31K | 10.03% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $12K | $12K | 3.80% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | DELTA DENTAL OF COLORADO | $2K | — | $2K | 2.79% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $3K | $8K | 17.15% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, CO 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $2K | $2K | 4.00% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $3K | $6K | 17.87% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $1K | $1K | 4.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 WEST 20TH STREET GREELEY, CO 80634 | EYEMED VISION CARE | $1K | — | $1K | 11.03% |
| SHIRAZI-MILLER BENEFITS LLC7 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $327 | $243 | $570 | 16.18% |
| NATIONAL BENEFIT CENTER7 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $141 | $141 | 4.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 SERVICE PROVIDER | Participant communication; Named fiduciary; Claims processing; Float revenue; Non-monetary compensation; Contract Administrator; Direct payment from the plan; Other services Service code 12 | — | $39K |
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 | 165 | 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) | 165 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 128 | $313K |
| Dental | DELTA DENTAL OF COLORADO | 181 | $66K |
| Vision | EYEMED VISION CARE | 162 | $9K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 257 | $45K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 165 | $34K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 165 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 257 | — |
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.