| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MARY E MATTESON3 | 12832 MAYFAIR WAY UNIT D ENGLEWOOD, CO 80112 | UNION SECURITY INSURANCE COMPANY | $30K | $121 | $30K | 11.72% |
| MARY E MATTESON3 | 4725 W QUINCY AVE, #808 DENVER, CO 80236 | SYMETRA FINANCIAL | $2K | — | $2K | 10.00% |
| MARY E MATTESON3 | 12832 MAYFAIR WAY #D ENGLEWOOD, CO 80112 | TRANSAMERICA LIFE INSURANCE CO. | $1K | — | $1K | 11.34% |
| BROKERS ASSISTANCE INC.3 | 8774 YATES DRIVE STE 100 WESTMINSTER, CO 80031 | TRANSAMERICA LIFE INSURANCE CO. | $203 | — | $203 | 1.55% |
| USI INSURANCE SERVICES LLC3 Filed as: USI COLORADO LLC | 1515 WYNKOOP SUITE 200 DENVER, CO 80202 | TRANSAMERICA LIFE INSURANCE CO. | $144 | — | $144 | 1.10% |
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 | 253 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 254 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 191 | $30K |
| Life insurance | UNION SECURITY INSURANCE COMPANY | 272 | $256K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 272 | $256K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 272 | $256K |
| Other(3 contracts, 3 carriers) | UNION SECURITY INSURANCE COMPANY | 272 | $285K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 272 | — |
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.