| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GINA M WESOLEK3 Filed as: GINA M. WESOLEK | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $2K | $605 | $3K | 9.39% |
| MARY CATHERINE WILLIAMS3 | 16319 EAST TENNESSEE AVENUE AURORA, CO 80017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $78 | $1K | 4.70% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | 111 SOUTH TEJON STREET COLORADO SPRINGS, CO 80903 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $90 | $1K | 4.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1100 EAST 6600 SOUTH SALT LAKE CITY, UT 84121 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $251 | — | $251 | 0.84% |
| KRISTEN ELISE RANDALL3 | 22 SOUTH GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $183 | $1 | $184 | 0.62% |
| D NASH AND ASSOCIATES3 Filed as: D NASH & ASSOCIATES | 7488 CAMERON DRIVE LARKSPUR, CO 80118 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $111 | — | $111 | 0.37% |
| OPTIO LLC3 Filed as: OPTIO LLC AND OTHER AGENTS | 8547 EAST ARAPAHOE ROAD GREENWOOD VILLAGE, CO 80112 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $19 | — | $19 | 0.06% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844663 DALLAS, TX 75284 | VISION SERVICE PLAN | $1K | — | $1K | 5.67% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844663 DALLAS, TX 75284 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $80 | $80 | 1.07% |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 194 | $82K |
| Vision | VISION SERVICE PLAN | 114 | $19K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 121 | $7K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 34 | $30K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 121 | $37K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 194 | — |
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.