| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INC3 | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $59K | $68K | $127K | 32.84% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | SUIT 101 2040 TERRY STREET LONGMONT, CO 80501 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 14.08% |
| MARY ALVARADO3 | 16522 GILPIN STREET THORNTON, CO 80602 | CONTINENTAL AMERICAN INSURANCE COMPANY | $4K | — | $4K | 10.25% |
| MARC JENKINS3 | 336 E 52ND AVE DENVER, CO 80216 | CONTINENTAL AMERICAN INSURANCE COMPANY | $970 | — | $970 | 2.42% |
| JAMES J SCHAMBER3 | 5700 E FRANKLIN RD STE 110 NAMPA, ID 83687 | CONTINENTAL AMERICAN INSURANCE COMPANY | $604 | — | $604 | 1.51% |
| ROBERT C BERTRAM3 | 9630 REMINGTON AVE FIRESTONE, CO 80504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $456 | — | $456 | 1.14% |
| JASON ANDERSON3 Filed as: JASON W ANDERSON | 2050 E 101ST CT THORNTON, CO 80229 | CONTINENTAL AMERICAN INSURANCE COMPANY | $290 | — | $290 | 0.72% |
| KATHERINE ANDERSON3 Filed as: KATHERINE S KEAST - ANDERSON | 3853 BUENA VISTA DR LOVELAND, CO 80538 | CONTINENTAL AMERICAN INSURANCE COMPANY | $240 | — | $240 | 0.60% |
| TANYA R BERTRAM3 | 9630 REMINGTON AVE FIRESTONE, CO 80504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $208 | — | $208 | 0.52% |
| ASHLEY LYNN DUDLEY3 Filed as: ASHLEY L DUDLEY | 2933 NEW CASTLE DR LOVELAND, CO 80538 | CONTINENTAL AMERICAN INSURANCE COMPANY | $136 | — | $136 | 0.34% |
| THERESA NETTO PHILLIPS3 Filed as: THERESA A CHAMBLISS | 10600 CHEVROLET WAY SUITE 202 ESTERO, FL 33928 | CONTINENTAL AMERICAN INSURANCE COMPANY | $98 | — | $98 | 0.24% |
| LISA M HALL3 | 2542 E SUNDOWN DR COEUR DALENE, ID 83815 | CONTINENTAL AMERICAN INSURANCE COMPANY | $57 | — | $57 | 0.14% |
| JONATHAN SAMUEL KIRKLAND3 Filed as: JONATHAN (JOSH) S KIRKLAND | 4245 MILGREN RD COLUMBUS, GA 31907 | CONTINENTAL AMERICAN INSURANCE COMPANY | $52 | — | $52 | 0.13% |
| KATHERINE ANDERSON3 Filed as: KATHERINE S KEAST-ANDERSON | 2050 EAST 101ST COURT THORNTON, CO 80239 | CONTINENTAL AMERICAN INSURANCE COMPANY | $49 | — | $49 | 0.12% |
| ROBERT C BERTRAM3 | 9630 REMINGTON N AVE FIRESTONE, CO 80504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $31 | — | $31 | 0.08% |
| RYAN DAVID BERTRAM3 Filed as: RYAN D BERTRAM | 9630 REMINGTON AVE FIRESTONE, CO 80504 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.07% |
| STACEY THOMAS CAMPBELL3 Filed as: STACEY T CAMPBELL | 1617 14TH AVE GREELEY, CO 80631 | CONTINENTAL AMERICAN INSURANCE COMPANY | $28 | — | $28 | 0.07% |
| LARRY W NICHOLSON3 Filed as: LARRY NICHOLSON | 1331 W MOREI ST 115 CHARLOTTE, NC 28208 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.07% |
| JOSE DE LOS SANTOS III3 Filed as: JOSE DE LOSE SANTOS III | 155 INVERENS S DRIVE WEST SUITE 300 ENGLEWOOD, CO 80112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $20 | — | $20 | 0.05% |
| TINA WAY3 Filed as: TINA R WAY | 155 INVERNESS DRIVE WEST ENGLEWOOD, CO 80122 | CONTINENTAL AMERICAN INSURANCE COMPANY | $18 | — | $18 | 0.04% |
| KIEFER GROUP INSURANCE AGENCY LLC3 | 12002 SOUTH MILONA DRIVE DRAPER, UT 84020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $14 | — | $14 | 0.03% |
| JAMES M GARNER3 | 640 GOOSEBE DR UNIT 303 LONGMONT, CO 80503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $7 | — | $7 | 0.02% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY ST STE 10 LONGMONT, CO 80501 | AMERITAS LIFE INSURANCE CORP. | $12K | $124 | $12K | 50.66% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CLAIMS PROCESSOR | Other services; Float revenue; Direct payment from the plan; Contract Administrator; Participant communication; Named fiduciary; Claims processing; Non-monetary compensation Service code 12 | — | $3K |
| CIGNA | Claims processing; Float revenue; Other services; Participant communication; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $0 |
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 | 310 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 310 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 143 | $388K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 213 | $24K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 213 | $24K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6 | $155K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6 | $155K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 6 | $155K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 310 | $550K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 310 | — |
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.