| 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 | UNITED HEALTHCARE INSURANCE COMPANY | $15K | — | $15K | 4.00% |
| KELLY LEBSACK3 Filed as: KELLY D LEBSACK | 2084 COVERED BRIDGE PARKWAY WINDSOR, CO 80550 | AFLAC | $2K | — | $2K | 4.85% |
| SEAN ANDREW FOSTER3 | PO BOX 276 WHITEWATER, CO 81527 | AFLAC | $1K | $343 | $1K | 3.63% |
| LAURA M MARCOTTE3 Filed as: LAURA PROBASCO | 4928 SILVERWOOD DR JOHNSTOWN, CO 80534 | AFLAC | $583 | $101 | $684 | 1.76% |
| MYWHY LLC3 | PO BOX 276 WHITEWATER, CO 81527 | AFLAC | $613 | $66 | $679 | 1.75% |
| RIGGS COUNSELMAN MICHAELS & DOWNES3 Filed as: GARRY RIGGS | 115 BAGGINS DR APT 204 FORT COLLINS, CO 80525 | AFLAC | $411 | — | $411 | 1.06% |
| RUSSELL ADELS3 | 11122 COUNTY ROAD 36 STERLING, CO 80751 | AFLAC | $274 | — | $274 | 0.71% |
| PILKINGTON FINANCIAL SERVICES INC3 | 226 SO 2ND ST PO BOX 1403 STERLING, CO 80751 | AFLAC | $229 | — | $229 | 0.59% |
| LUKE ARTZER3 | PO BOX 1553 WEATHERFORD, TX 76086 | AFLAC | $185 | — | $185 | 0.48% |
| KATHERINE ANDERSON3 | 2050 E 101ST CT THORNTON, CO 80229 | AFLAC | $89 | — | $89 | 0.23% |
| JASON ANDERSON3 | 2050 E 101ST CT THORNTON, CO 80229 | AFLAC | $85 | — | $85 | 0.22% |
| BRENDA J MCGINNIS3 | 1279 APOLLO RD ARAB, AL 35016 | AFLAC | $69 | — | $69 | 0.18% |
| CERI D ARTZER3 | PO BOX 1553 WEATHERFORD, TX 76086 | AFLAC | $59 | — | $59 | 0.15% |
| DANIEL L FRENCH3 | 240 43RD AVE GREELEY, CO 80634 | AFLAC | $44 | $11 | $55 | 0.14% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA A CHAMBLISS | 2059 PINE RIVER DRIVE KINGWOOD, TX 77339 | AFLAC | $47 | — | $47 | 0.12% |
| RUBEN J MANZANARES3 | 4547 HAYLER AVE LOVELAND, CO 80538 | AFLAC | $35 | $7 | $42 | 0.11% |
| CHAD T ATWOOD3 | 1422 MERRIAMS DR SEVERANCE, CO 80550 | AFLAC | $31 | — | $31 | 0.08% |
| LARRY W NICHOLSON3 | 130 N SHELMORE BLVD MT PLEASANT, SC 29464 | AFLAC | $24 | — | $24 | 0.06% |
| JEFFREY JOSEPH HALL3 | 3007 W OLIVE ST FORT COLLINS, CO 80521 | AFLAC | $21 | — | $21 | 0.05% |
| JONATHAN SAMUEL KIRKLAND3 | 1270 HOPEWELL CRST ALPHARETTA, GA 30004 | AFLAC | $20 | — | $20 | 0.05% |
| TROY J KIDD3 | 4071 E 126TH PL THORNTON, CO 80241 | AFLAC | $19 | — | $19 | 0.05% |
| BRIAN W PATTEN3 | 120 MARGUERITE DR SUITE 101 CRANBERRY TOWNSHIP, PA 16066 | AFLAC | $15 | — | $15 | 0.04% |
| STEPHANIE FARRELL3 | 8670 WOLFF CT STE 290 WESTMINSTER, CO 80031 | AFLAC | $12 | — | $12 | 0.03% |
| SUSAN MOSER3 Filed as: SUSAN K MOSER | 10264 LAKOTA CT DEMOTTE, IN 46310 | AFLAC | $12 | — | $12 | 0.03% |
| MICHELLE A JOHNSON3 | 437 CR 83 SIDNEY, NE 69162 | AFLAC | $10 | — | $10 | 0.03% |
| JOHN P THOMPSON3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $6 | — | $6 | 0.02% |
| DANIEL C HARRIS3 | 413 OAK RIDGE CT MARS, PA 16046 | AFLAC | $3 | — | $3 | 0.01% |
| JOSE DE LOS SANTOS III3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $3 | — | $3 | 0.01% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $2 | — | $2 | 0.01% |
| CHRISTOPHER PAUL FARGOTSTEIN3 | 120 MARGUERITE DR CRANBERRY TWP, PA 16066 | AFLAC | $2 | — | $2 | 0.01% |
| NICHOLAS DEAN SHIPE3 | 11037 BROADWAY STE C CROWN POINT, IN 46307 | AFLAC | $2 | — | $2 | 0.01% |
| SARA BRIERY3 Filed as: SARA E BRIERY | 4 MARBURG LN SAVANNAH, GA 31411 | AFLAC | $2 | — | $2 | 0.01% |
| BRENDAN W DEASY3 | PO BOX 278 CHINO, CA 91708 | AFLAC | $1 | — | $1 | 0.00% |
| HEATHER BARTLEY3 | 120 MARGUERITE DR STE 101 CRANBERRY TWP, PA 16066 | AFLAC | $1 | — | $1 | 0.00% |
| KATHERINE ANDERSON3 Filed as: KATHERINE S KEAST-ANDERSON | 2050 EAST 101ST COURT THORNTON, CO 80239 | CONTINENTAL AMERICAN INSURANCE COMPANY | $138 | — | $138 | 2.17% |
| JOHN D REEVES3 | 7738 PRAIRIE LAKE TR PARKER, CO 80134 | CONTINENTAL AMERICAN INSURANCE COMPANY | $88 | — | $88 | 1.38% |
| JAMES M GARNER3 | 640 GOOSEBERRY DR UNIT 303 LONGMONT, CO 80503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $59 | — | $59 | 0.93% |
| PILKINGTON FINANCIAL SERVICES INC3 Filed as: PILKINGTON FINANCIAL SERVICES LTD | 226 SO 2ND ST STERLING, CO 80751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $56 | — | $56 | 0.88% |
| TROY J KIDD3 | 13066 EMERSON ST THORNTON, CO 80241 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | — | $31 | 0.49% |
| RUSSELL ADELS3 | 226 S 2ND ST STERLING, CO 80751 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.46% |
| KIEFER GROUP INSURANCE AGENCY LLC3 | 12002 SOUTH MILONA DRIVE DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.28% |
| JASON ANDERSON3 Filed as: JASON W ANDERSON | 2050 E 101ST CT THORNTON, CO 80229 | CONTINENTAL AMERICAN INSURANCE COMPANY | $16 | — | $16 | 0.25% |
| LARRY W NICHOLSON3 Filed as: LARRY NICHOLSON | 1331 W MOREHEAD ST SUITE 115 CHARLOTTE, NC 28208 | CONTINENTAL AMERICAN INSURANCE COMPANY | $13 | — | $13 | 0.20% |
| JOSE DE LOS SANTOS III3 | 155 INVERNESS DR WEST SUITE 300 ENGLEWOOD, CO 80122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $9 | — | $9 | 0.14% |
| TINA WAY3 | 155 INVERNESS DR WEST SUITE 300 ENGLEWOOD, CO 80122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.11% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | ANTHEM LIFE INSURANCE COMPANY | $3K | — | $3K | 47.38% |
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 | 83 | 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) | 83 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 36 | $407K |
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC. | 48 | $19K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE INC. | 48 | $19K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 83 | $5K |
| Short-term disability | CONTINENTAL AMERICAN INSURANCE COMPANY | 15 | $6K |
| Other | ANTHEM LIFE INSURANCE COMPANY | 83 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 83 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.