| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | UNITEDHEALTHCARE INSURANCE COMPANY | $13K | — | $13K | 3.61% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 2084 COVERED BRIDGE PARKWAY WINDSOR, CO 80550 | AFLAC | $9K | $27 | $9K | 21.15% |
| ASHLEY LYNN DUDLEY3 | 2933 NEW CASTLE DR LOVELAND, CO 80538 | AFLAC | $2K | $6 | $2K | 4.79% |
| LAURA M MARCOTTE3 Filed as: LAURA PROBASCO | 4928 SILVERWOOD DR JOHNSTOWN, CO 80534 | AFLAC | $2K | $6 | $2K | 3.45% |
| SEAN ANDREW FOSTER3 | PO BOX 276 WHITEWATER, CO 81527 | AFLAC | $260 | — | $260 | 0.58% |
| MYWHY LLC3 | PO BOX 276 WHITEWATER, CO 81527 | AFLAC | $260 | — | $260 | 0.58% |
| LUKE ARTZER3 | PO BOX 1553 WEATHERFORD, TX 76086 | AFLAC | $199 | — | $199 | 0.45% |
| PILKINGTON FINANCIAL SERVICES INC3 | 226 SO 2ND ST PO BOX 1403 STERLING, CO 80751 | AFLAC | $114 | — | $114 | 0.26% |
| BRENDA J MCGINNIS3 | 1279 APOLLO RD ARAB, AL 35016 | AFLAC | $76 | — | $76 | 0.17% |
| CERI DARLENE ARTZER3 | 2520 BOYD RD GRANBURY, TX 76049 | AFLAC | $55 | — | $55 | 0.12% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA A CHAMBLISS | 2059 PINE RIVER DRIVE KINGWOOD, TX 77339 | AFLAC | $48 | — | $48 | 0.11% |
| KATHERINE ANDERSON3 | 2050 E 101ST CT THORNTON, CO 80229 | AFLAC | $42 | — | $42 | 0.09% |
| JASON ANDERSON3 | 14811 RIO RANCHO WAY HELOTES, TX 78023 | AFLAC | $31 | — | $31 | 0.07% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: GARRY RIGGS | 115 BAGGINS DR APT 204 FORT COLLINS, CO 80525 | AFLAC | $27 | — | $27 | 0.06% |
| CHAD T ATWOOD3 | 1422 MERRIAMS DR SEVERANCE, CO 80550 | AFLAC | $19 | — | $19 | 0.04% |
| JONATHAN SAMUEL KIRKLAND3 | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $19 | — | $19 | 0.04% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: DANIEL FRENCH | 230 43RD AVE GREELEY, CO 80634 | AFLAC | $15 | — | $15 | 0.03% |
| MICHELLE A JOHNSON3 | 437 CR 83 SIDNEY, NE 69162 | AFLAC | $13 | — | $13 | 0.03% |
| COLLEEN J LEBSACK3 | 5048 FAWN RIDGE WAY CASTLE ROCK, CO 80104 | AFLAC | $12 | — | $12 | 0.03% |
| ROBERT MOLLENDOR3 | 625 MINDY CT STERLING, CO 80751 | AFLAC | $10 | — | $10 | 0.02% |
| RUSSELL ADELS3 | 11122 COUNTY ROAD 36 STERLING, CO 80751 | AFLAC | $9 | — | $9 | 0.02% |
| LARRY W NICHOLSON3 | 130 N SHELMORE BLVD MT PLEASANT, SC 29464 | AFLAC | $8 | — | $8 | 0.02% |
| JEFFREY JOSEPH HALL3 | 2334 GOLD DUST LN HIGHLANDS RANCH, CO 80129 | AFLAC | $7 | — | $7 | 0.02% |
| JOHN P THOMPSON3 Filed as: JOHN P THOMPSON SR | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $6 | — | $6 | 0.01% |
| TROY J KIDD3 | 12942 LEYDEN ST THORNTON, CO 80602 | AFLAC | $6 | — | $6 | 0.01% |
| VICTOR M GLAZE3 | 402 PLOWMAN CT FORT COLLINS, CO 80526 | AFLAC | $6 | — | $6 | 0.01% |
| DAVID V PAYNE | 225 EAGLE CT MONROE, MI 48162 | AFLAC | $3 | — | $3 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $2 | — | $2 | 0.00% |
| JOSE DE LOS SANTOS III3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $2 | — | $2 | 0.00% |
| SARA BRIERY3 Filed as: SARA E BRIERY | 2709 AIMAR AVE. SAVANNAH, GA 31406 | AFLAC | $2 | — | $2 | 0.00% |
| LARRY W NICHOLSON | 1341 WALES DR FORT MYERS, FL 33901 | AFLAC | $2 | — | $2 | 0.00% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 W 20TH ST GREELEY, CO 80634 | THE STANDARD | $3K | — | $3K | 13.19% |
| CENTERSTONE INSURANCE AND FINANCIAL Filed as: CENTERSTONE INS FIN SERVICE | 12404 PARK CENTRAL DR, STE 4005 DALLAS, TX 75251 | THE STANDARD | $756 | — | $756 | 3.41% |
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 | 79 | 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) | 79 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 31 | $398K |
| Dental | THE STANDARD | 85 | $22K |
| Vision | THE STANDARD | 85 | $22K |
| Life insurance | THE STANDARD | 85 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 85 | — |
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.