| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMA, INC.3 | 1705 17TH STREET, SUITE 100 DENVER, CO 80202 | DELTA DENTAL OF COLORADO | $8K | $0 | $8K | 5.00% |
| IMA, INC.3 | 1705 17TH STREET, SUITE 100 DENVER, CO 80202 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $0 | $8K | 13.61% |
| IMA, INC.3 | PO BOX 733835 DALLAS, TX 75373 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $479 | $479 | 0.81% |
| LEXTOR CORPORATION3 | 600 WEST COUNTY LINE ROAD SUITE 15-202 HIGHLANDS RANCH, CO 80129 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | $0 | $4K | 11.05% |
| IMA, INC.3 | 430 E DOUGLAS AVENUE, SUITE 400 WICHITA, KS 67202 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3K | $0 | $3K | 8.08% |
| LINDSAY A LIJEWSKI3 Filed as: LINDSAY A. LIJEWSKI | 5894 EAST CALEY AVENUE CENTENNIAL, CO 80111 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2K | $0 | $2K | 4.48% |
| DAYTON LLC3 Filed as: DAYTON, LLC | 5445 DTC PARKWAY, SUITE 1036 GREENWOOD VILLAGE, CO 80111 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | $0 | $1K | 3.34% |
| AMY JOY DRILLING3 | 600 WEST COUNTY LINE ROAD SUITE 15-201 HIGHLANDS RANCH, CO 80129 | CONTINENTAL AMERICAN INSURANCE COMPANY | $3 | $0 | $3 | 0.01% |
| IMA, INC.3 | 1705 17TH STREET, SUITE 100 DENVER, CO 80202 | EMBER ASSURANCE, INC. | $3K | $0 | $3K | 9.99% |
| FREEDOM INSIGHT, LLC4 | PMB 329 6510-A SOUTH ACADEMY BLVD COLORADO SPRINGS, CO 80906 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | $0 | $2K | 15.39% |
| DONALD ANDERSON4 | 1818 HERCULES DRIVE COLORADO SPRINGS, CO 80905 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $194 | $0 | $194 | 1.66% |
| BLUMCIA BUSINESS SOLUTIONS4 | PMB 271 3440 YOUNGFIELD STREET WHEAT RIDGE, CO 80033 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $34 | — | $34 | 0.29% |
| SHERRY SWEDENBORG4 Filed as: SHERRY L. SWEDENBORG | 4400 SOUTH MONACO STREET, SUITE 228 DENVER, CO 80237 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $23 | $0 | $23 | 0.20% |
No Schedule C service providers reported on this filing.
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 | 350 | 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) | 350 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 476 | $156K |
| Vision | EMBER ASSURANCE, INC. | 458 | $27K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 350 | $59K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 350 | $59K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 350 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 476 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.