| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| OBGB INC.3 Filed as: OBGB INC | 5331 RETREAT CIR LONGMONT, CO 80503 | STANDARD INSURANCE COMPANY | $4K | $1K | $5K | — |
| OBGB INC.3 Filed as: OBGB, INC, | 5331 RETREAT CIR LONGMONT, CO 80503 | STANDARD INSURANCE COMPANY | $4K | $1K | $5K | — |
| OBGB INC.3 Filed as: OBGB, INC | 5331 RETREAT CIR LONGMONT, CO 80503 | KAISER FOUNDATION HEALTH PLAN OF COLORADO | $105K | $6K | $111K | — |
| OBGB INC.3 Filed as: OBGB INC | 5331 RETREAT CIR LONGMONT, CO 80503 | STANDARD INSURANCE COMPANY | $957 | $151 | $1K | — |
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 | 541 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 546 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN OF COLORADO | 541 | $0 |
| Dental | STANDARD INSURANCE COMPANY | 428 | $0 |
| Life insurance | STANDARD INSURANCE COMPANY | 424 | $0 |
| Long-term disability | STANDARD INSURANCE COMPANY | 426 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 541 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.