| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $18K | — | $18K | 9.18% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS | 4600 S SYRACUSE ST STE 1250 DENVER, CO 80237 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 3.56% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $784 | $784 | 0.40% |
| RUSSELL ADELS3 | 11122 COUNTY ROAD 36 STERLING, CO 80751 | AFLAC | $4K | $72 | $4K | 10.51% |
| PILKINGTON FINANCIAL SERVICES INC3 | 226 SO 2ND ST PO BOX 1403 STERLING, CO 80751 | AFLAC | $2K | — | $2K | 6.13% |
| KATHERINE ANDERSON3 | 2050 E 101ST CT THORNTON, CO 80229 | AFLAC | $929 | $21 | $950 | 2.37% |
| JASON ANDERSON3 | 2050 E 101ST CT THORNTON, CO 80229 | AFLAC | $918 | $21 | $939 | 2.34% |
| LUKE ARTZER3 | PO BOX 1553 WEATHERFORD, TX 76086 | AFLAC | $281 | — | $281 | 0.70% |
| CHAD T ATWOOD3 | 1511 60TH AVE GREELEY, CO 80634 | AFLAC | $241 | — | $241 | 0.60% |
| JEFFREY JOSEPH HALL | 417 W MYRTLE ST FORT COLLINS, CO 80521 | AFLAC | $229 | — | $229 | 0.57% |
| BRENDA J MCGINNIS3 | 5003 PATRIOT PARK CIR SE OWENS CROSS ROADS, AL 35763 | AFLAC | $207 | — | $207 | 0.52% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA A CHAMBLISS | 2059 PINE RIVER DRIVE KINGWOOD, TX 77339 | AFLAC | $152 | — | $152 | 0.38% |
| MICHELLE A JOHNSON3 | 437 CR 83 SIDNEY, NE 69162 | AFLAC | $133 | — | $133 | 0.33% |
| CERI D ARTZER3 | PO BOX 1553 WEATHERFORD, TX 76086 | AFLAC | $104 | — | $104 | 0.26% |
| LARRY W NICHOLSON3 | 116 E MAIN ST ROCK HILL, SC 29730 | AFLAC | $79 | — | $79 | 0.20% |
| ROBERT MOLLENDOR3 | 625 MINDY CT STERLING, CO 80751 | AFLAC | $78 | — | $78 | 0.19% |
| JONATHAN SAMUEL KIRKLAND3 | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $54 | — | $54 | 0.13% |
| TROY J KIDD3 | 13066 EMERSON ST THORNTON, CO 80241 | AFLAC | $41 | — | $41 | 0.10% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 2004 STRATTON HILLS CT GREENSBORO, NC 27410 | AFLAC | $38 | — | $38 | 0.09% |
| SUSAN MOSER3 Filed as: SUSAN K MOSER | 10264 LAKOTA CT DEMOTTE, IN 46310 | AFLAC | $16 | $10 | $26 | 0.06% |
| JOHN P THOMPSON3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $24 | — | $24 | 0.06% |
| TROY J KIDD | 13061 EMERSON ST THORNTON, CO 80241 | AFLAC | $23 | — | $23 | 0.06% |
| JOHN D REEVES3 Filed as: JOHN D REEVES III | 7738 PRAIRIE LAKE TRAIL PARKER, CO 80134 | AFLAC | $21 | — | $21 | 0.05% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR SUITE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $13 | $5 | $18 | 0.04% |
| J THEIS & ASSOCIATES INC3 | 1825 DUVAL DR LAUREL, MT 59044 | AFLAC | $18 | — | $18 | 0.04% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 2084 COVERED BRIDGE PKWY WINDSOR, CO 80550 | AFLAC | $17 | — | $17 | 0.04% |
| JOSE DE LOS SANTOS III3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $16 | — | $16 | 0.04% |
| JAMES M GARNER3 | 1301 ARAPAHOE ST STE 105 GOLDEN, CO 80401 | AFLAC | $14 | — | $14 | 0.03% |
| DAVID A LYSNE | 1426 24TH AVE S MOORHEAD, MN 56560 | AFLAC | $14 | — | $14 | 0.03% |
| STEPHANIE FARRELL3 | 8670 WOLFF CT STE 290 WESTMINSTER, CO 80031 | AFLAC | $12 | — | $12 | 0.03% |
| DAVID R CHARLES3 | 1791 TWIN PINE BLVD GULF BREEZE, FL 32563 | AFLAC | $10 | — | $10 | 0.02% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $9 | — | $9 | 0.02% |
| TINA WAY3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $8 | — | $8 | 0.02% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $7 | — | $7 | 0.02% |
| KIEFER GROUP INSURANCE AGENCY LLC3 | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80112 | AFLAC | $6 | — | $6 | 0.01% |
| LISA M HALL3 | 2542 E SUNDOWN DR COEUR DALENE, ID 83815 | AFLAC | $4 | — | $4 | 0.01% |
| NICHOLAS DEAN SHIPE3 | 11037 BROADWAY STE C CROWN POINT, IN 46307 | AFLAC | $2 | $2 | $4 | 0.01% |
| BRENDAN W DEASY3 | 534 W 7TH AVE WEST HOMESTEAD, PA 15120 | AFLAC | $2 | $1 | $3 | 0.01% |
| CHRISTOPHER PAUL FARGOTSTEIN3 | 120 MARGUERITE DR CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $3 | — | $3 | 0.01% |
| DANIEL C HARRIS | 124 CARTERS GROVE DR GIBSONIA, PA 15044 | AFLAC | $2 | $1 | $3 | 0.01% |
| VICTOR M GLAZE | 402 PLOWMAN CT FORT COLLINS, CO 80526 | AFLAC | $3 | — | $3 | 0.01% |
| DANIEL C HARRIS3 | 4110 WILLOW CREEK DR GIBSONIA, PA 15044 | AFLAC | $2 | — | $2 | 0.00% |
| LAWRENCE A ELMORE3 | PO BOX 244 MORRISON, CO 80465 | AFLAC | $2 | — | $2 | 0.00% |
| HEATHER BARTLEY3 | 120 MARGUERITE DR SUITE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $2 | — | $2 | 0.00% |
| SARA BRIERY3 Filed as: SARA E BRIERY | 4 MARBURG LN SAVANNAH, GA 31411 | AFLAC | $2 | — | $2 | 0.00% |
| MICHAEL D EVANS JR Filed as: MICHAEL J TOMLINSON | 40 PARADISE DR WATERTOWN, SD 57201 | AFLAC | $1 | — | $1 | 0.00% |
| DAVID V PAYNE | 225 EAGLE CT MONROE, MI 48162 | AFLAC | $1 | — | $1 | 0.00% |
| PILKINGTON FINANCIAL SERVICES INC3 Filed as: PILKINGTON FINANCIAL SERVICES LTD | 226 SO 2ND ST STERLING, CO 80751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $833 | — | $833 | 4.38% |
| KATHERINE ANDERSON3 Filed as: KATHERINE S KEAST-ANDERSON | 3853 BUENA VISTA DRIVE LOVELAND, CO 80538 | CONTINENTAL AMERICAN INSURANCE COMPANY | $403 | — | $403 | 2.12% |
| RUSSELL ADELS3 | 226 S 2ND ST STERLING, CO 80751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $366 | — | $366 | 1.92% |
| JASON ANDERSON3 Filed as: JASON W ANDERSON | 2050 E 101ST CT THORNTON, CO 80229 | CONTINENTAL AMERICAN INSURANCE COMPANY | $214 | — | $214 | 1.12% |
| JOHN D REEVES3 | 7738 PRAIRIE LAKE TR PARKER, CO 80134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $184 | — | $184 | 0.97% |
| TROY J KIDD3 | 13066 EMERSON ST THORNTON, CO 80241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $180 | — | $180 | 0.95% |
| JAMES M GARNER3 | 640 GOOSEBE DR UNIT 303 LONGMONT, CO 80503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $117 | — | $117 | 0.61% |
| KIEFER GROUP INSURANCE AGENCY LLC3 | 12002 SOUTH MILONA DRIVE DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $62 | — | $62 | 0.33% |
| LARRY W NICHOLSON3 Filed as: LARRY NICHOLSON | 1331 W MOREHEAD ST SUITE 115 CHARLOTTE, NC 28208 | CONTINENTAL AMERICAN INSURANCE COMPANY | $50 | — | $50 | 0.26% |
| JOSE DE LOS SANTOS III3 | 155 INVERNESS DR WEST SUITE 300 ENGLEWOOD, CO 80122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $23 | — | $23 | 0.12% |
| LISA M HALL3 | 2542 E SUNDOWN DR COEUR DALENE, ID 83815 | CONTINENTAL AMERICAN INSURANCE COMPANY | $17 | — | $17 | 0.09% |
| TINA WAY3 | 155 INVERNESS DR WEST SUITE 300 ENGLEWOOD, CO 80122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $15 | — | $15 | 0.08% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 41.37% |
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 | 123 | 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) | 123 | 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 | 62 | $236K |
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC. | 59 | $19K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC. | 59 | $19K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 123 | $7K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 163 | $19K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 123 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 163 | — |
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.