| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PFS INSURANCE GROUP LLC3 | 4848 THOMPSON PARKWAY STE 200 JOHNSTOWN, CO 80534 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $3K | — | $3K | 0.39% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCIAL | SERVICES INC. 12404 PARK CENTRAL DR, STE 400 DALLAS, TX 75251 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $324 | — | $324 | 0.04% |
| GBS BENEFITS INC3 | 2040 TERRY ST LONGMONT, CO 80501 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $8K | $8K | 2.56% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO, LLC | 2040 TERRY ST STE #101 LONGMONT, CO 80501 | GUARDIAN | $9K | — | $9K | 9.76% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO, LLC | 2040 TERRY ST LONGMONT, CO 80501 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 12.11% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $2K | $2K | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIM PROCESSING | Claims processing; Contract Administrator; Float revenue; Non-monetary compensation; Named fiduciary; Participant communication; Direct payment from the plan; Other services Service code 12 | — | $1K |
| CIGNA | Float revenue; Contract Administrator; Named fiduciary; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Participant communication Service code 12 | — | $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 | 196 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 196 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 195 | $1.2M |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 322 | $407K |
| Vision(2 contracts, 2 carriers) | GUARDIAN | 322 | $137K |
| Life insurance(2 contracts, 2 carriers) | GUARDIAN | 322 | $137K |
| Short-term disability(2 contracts, 2 carriers) | GUARDIAN | 322 | $137K |
| Long-term disability(2 contracts, 2 carriers) | GUARDIAN | 322 | $137K |
| Other(2 contracts, 2 carriers) | GUARDIAN | 322 | $137K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 322 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.