| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOUNTAIN WEST INSURANCE3 | 100 E VICTORY WAY CRAIG, CO 81625 | SUN LIFE ASSURANCE COMPANY OF CANADA | $8K | — | $8K | 9.72% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPLOYEE BENEFIT MGMT SERVICES, INC EIN 81-0391256 ACA SERVICES | Contract Administrator; Other fees Service code 13 | — | $104K |
| MOUNTAIN WEST INSURANCE & FINANCIAL EIN 52-2364820 BROKER | Insurance agents and brokers Service code 22 | — | $43K |
| COFINITY EIN 20-1274723 PPO | Other services Service code 49 | — | $14K |
| EMPLOYEE BENEFIT MGMT SERVICES INC EIN 81-0391256 UTILIZATION REVIEW | Other fees Service code 99 | — | $12K |
| WESTERN HEALTHCARE ALLIANCE EIN 84-1159443 BROKER | Insurance agents and brokers Service code 22 | — | $8K |
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 | 264 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 265 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 376 | $10K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 413 | $81K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 413 | $81K |
| Prescription drug | HCC LIFE INSURANCE COMPANY | 521 | $487K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 521 | $487K |
| Other | SUN LIFE ASSURANCE COMPANY OF CANADA | 413 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 521 | — |
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."
No prospect flags tripped on this filing.