| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $11K | — | $11K | 9.55% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY & FIN SVCS | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $4K | $4K | 3.70% |
| PILKINGTON FINANCIAL SERVICES INC Filed as: PILKINGTON FINANCIAL SERVICES LTD | 226 SO 2ND ST STERLING, CO 80751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 7.97% |
| TROY J KIDD Filed as: TROY KIDD | 13066 EMERSON ST THORNTON, CO 80241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $481 | — | $481 | 3.06% |
| RUSSELL ADELS | 226 SO 2ND ST STERLING, CO 80751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $371 | — | $371 | 2.36% |
| KATHERINE ANDERSON | 2050 E 101ST CT THORNTON, CO 80239 | CONTINENTAL AMERICAN INSURANCE COMPANY | $231 | — | $231 | 1.47% |
| LARRY W NICHOLSON Filed as: LARRY NICHOLSON | 861 N AUBURNDALE ST MEMPHIS, TN 38107 | CONTINENTAL AMERICAN INSURANCE COMPANY | $174 | — | $174 | 1.11% |
| JOHN D REEVES Filed as: JOHN REEVES III | 7738 PRAIRIE LAKE TRAIL PARKER, CO 80134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $146 | — | $146 | 0.93% |
| JAMES M GARNER Filed as: JAMES GARNER | 8670 WOLFF CT, STE 290 WESTMINSTER, CO 80031 | CONTINENTAL AMERICAN INSURANCE COMPANY | $93 | — | $93 | 0.59% |
| KIEFER GROUP INSURANCE AGCY LLC | 12002 SOUTH MILONA DR DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $52 | — | $52 | 0.33% |
| LISA HALL | 2542 E SUNDOWN DR COEUR D ALENE, ID 83815 | CONTINENTAL AMERICAN INSURANCE COMPANY | $45 | — | $45 | 0.29% |
| JOSE DE LOS SANTOS III | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.10% |
| TINA WAY | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.08% |
| RUSSELL ADELS | 11122 COUNTY ROAD 36 STERLING, CO 80751 | AFLAC | $649 | — | $649 | 5.65% |
| ROHIT J DASS | 5979 S LITTLE RIVER WAY AURORA, CO 80016 | AFLAC | $485 | — | $485 | 4.22% |
| TROY J KIDD Filed as: TROY KIDD | 13066 EMERSON ST THORNTON, CO 80241 | AFLAC | $415 | — | $415 | 3.61% |
| PILKINGTON FINANCIAL SERVICES INC | 226 SO 2ND ST STERLING, CO 80751 | AFLAC | $404 | — | $404 | 3.52% |
| LARRY W NICHOLSON Filed as: LARRY NICHOLSON | 116 E MAIN ST ROCK HILL, SC 29730 | AFLAC | $225 | — | $225 | 1.96% |
| LUKE ARTZER | 451 STONERIDGE TRAIL WEATHERFORD, TX 76087 | AFLAC | $154 | — | $154 | 1.34% |
| BRENDA J MCGINNIS Filed as: BRENDA MCGINNIS | 90 BRASWELL RD GUNTERSVILLE, AL 35976 | AFLAC | $120 | — | $120 | 1.04% |
| THERESA CHAMBLISS | 2059 PINE RIVER DR KINGWOOD, TX 77339 | AFLAC | $87 | — | $87 | 0.76% |
| MICHELLE A JOHNSON Filed as: MICHELLE JOHNSON | 437 CR 83 SIDNEY, NE 69162 | AFLAC | $80 | — | $80 | 0.70% |
| CERI ARTZER | 451 STONERIDGE TRAIL WEATHERFORD, TX 76087 | AFLAC | $60 | — | $60 | 0.52% |
| ROBERT MOLLENDOR | 117 CORTEZ ST STERLING, CO 80751 | AFLAC | $31 | — | $31 | 0.27% |
| JOHNATHAN KIRKLAND | 4245 MILGEN RD COLUMBUS, GA 31907 | AFLAC | $30 | — | $30 | 0.26% |
| KELLY LEBSACK | 826 N ELM ST GREENSBORO, NC 27401 | AFLAC | $25 | — | $25 | 0.22% |
| KATHERINE ANDERSON | 2050 E 101ST CT THORNTON, CO 80229 | AFLAC | $23 | — | $23 | 0.20% |
| JOHN THOMPSON | 6395 S KEWAUNEE WAY, STE 425 AURORA, CO 80016 | AFLAC | $14 | — | $14 | 0.12% |
| JOHN D REEVES Filed as: JOHN REEVES III | 7738 PRAIRIE LAKE TRAIL PARKER, CO 80134 | AFLAC | $12 | — | $12 | 0.10% |
| STEPHANIE FARRELL | 8670 WOLFF CT, STE 290 WESTMINSTER, CO 80031 | AFLAC | $10 | — | $10 | 0.09% |
| JOSE DE LOS SANTOS III | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $9 | — | $9 | 0.08% |
| JAMES M GARNER Filed as: JAMES GARNER | 14143 DENVER WEST PKWY, STE 100 GOLDEN, CO 80401 | AFLAC | $6 | — | $6 | 0.05% |
| LISA HALL | 2542 E SUNDOWN DR COEUR D ALENE, ID 83815 | AFLAC | $5 | — | $5 | 0.04% |
| DAVID R CHARLES Filed as: DAVID CHARLES | 1791 TWIN PINE BLVD GULF BREEZE, FL 32563 | AFLAC | $5 | — | $5 | 0.04% |
| J THEIS & ASSOCIATES INC Filed as: J THEIS & ASSOCIATES, INC. | 960 S 24TH ST W, STE H BILLINGS, MT 59102 | AFLAC | $5 | — | $5 | 0.04% |
| TINA WAY | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $5 | — | $5 | 0.04% |
| ALLISON FARRIS WENDELBERGER | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $4 | — | $4 | 0.03% |
| KIEFER GROUP INSURANCE AGCY LLC | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80112 | AFLAC | $3 | — | $3 | 0.03% |
| SARA BRIERY | 4 MARBURG LN SAVANNAH, GA 31411 | AFLAC | $1 | — | $1 | 0.01% |
| LAWRENCE A ELMORE Filed as: LAWRENCE ELMORE | PO BOX 244 MORRISON, CO 80465 | AFLAC | $1 | — | $1 | 0.01% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W. 20TH ST GREELEY, CO 80634 | ANTHEM LIFE INSURANCE COMPANY | $2K | — | $2K | 40.77% |
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 | 204 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 76 | $131K |
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 59 | $10K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 59 | $10K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 204 | $4K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 76 | $16K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 204 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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.