| 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 | $3K | $801 | $4K | 10.25% |
| 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 | $2K | $60 | $2K | 4.86% |
| TERESA MARY ROBERSON3 | 711 CASTLE ROAD COLORADO SPRINGS, CO 80904 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $59 | $1K | 3.68% |
| MARY CATHERINE WILLIAMS3 | 16319 EAST TENNESSEE AVENUE AURORA, CO 80017 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $978 | $152 | $1K | 3.13% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC. | 191 TELLURIDE STREET BRIGHTON, CO 80601 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $421 | $607 | $1K | 2.84% |
| 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 | $231 | — | $231 | 0.64% |
| KRISTEN ELISE RANDALL3 Filed as: KRISTEN E. RANDALL AND OTHER AGENTS | 22 SOUTH GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $201 | $1 | $202 | 0.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCES., INC. | PO BOX 844663 DALLAS, TX 75284 | VISION SERVICE PLAN | $1K | — | $1K | 5.47% |
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 | 154 | 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) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 224 | $91K |
| Vision | VISION SERVICE PLAN | 145 | $22K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 154 | $13K |
| Short-term disability | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 45 | $36K |
| Other(2 contracts, 2 carriers) | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | 154 | $50K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 224 | — |
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.