| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOUTAINSIDE INSURANCE MANAGEMENT3 | 2000 WEST 104TH AVENUE DENVER, CO 80234 | HCC LIFE INSURANCE COMPANY | $66K | — | $66K | 10.00% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | PO BOX 100 EASTLAKE, CO 80614 | DELTA DENTAL OF COLORADO | $10K | — | $10K | 9.99% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | DELTA DENTAL OF COLORADO | $4K | — | $4K | 4.00% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | P O BOX 100 EASTLAKE, CO 80614 | AMERICAN FIDELITY ASSURANCE COMPANY | $5K | — | $5K | 5.00% |
| CADA INSURANCE SERVICES INC3 | 290 SPEER BOULEVARD DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 3.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 2.59% |
| COLORADO AUTO DEALERS ASSOCIATION3 | — | AMERICAN FIDELITY ASSURANCE COMPANY | — | $746 | $746 | 0.77% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $3K | — | $3K | 10.78% |
| CADA INSURANCE SERVICES INC3 | 290 SPEER BOULEVARD DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $666 | — | $666 | 2.77% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | P O BOX 100 EASTLAKE, CO 80614 | AMERICAN FIDELITY ASSURANCE COMPANY | $445 | — | $445 | 1.85% |
| COLORADO AUTO DEALERS ASSOCIATION3 | — | AMERICAN FIDELITY ASSURANCE COMPANY | — | $215 | $215 | 0.89% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $1K | — | $1K | 4.81% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | P O BOX 100 EASTLAKE, CO 80614 | AMERICAN FIDELITY ASSURANCE COMPANY | $449 | — | $449 | 2.00% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 Filed as: MOUNTAINSIDE INSURANCE MANAGEMENT L | PO BOX 100 EASTLAKE, CO 80614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | PO BOX 100 EASTLAKE, CO 80614 | EMBER ASSURANCE, INC. | $1K | — | $1K | 10.01% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE | 12404 PARK CENTRAL DRIVE SUITE 400S DALLAS, TX 75251 | EMBER ASSURANCE, INC. | $435 | — | $435 | 4.00% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $351 | — | $351 | 4.55% |
| CADA INSURANCE SERVICES INC3 | 290 SPEER BOULEVARD DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $231 | — | $231 | 2.99% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | PO BOX 100 EASTLAKE, CO 80614 | AMERICAN FIDELITY ASSURANCE COMPANY | $154 | — | $154 | 2.00% |
| COLORADO AUTO DEALERS ASSOCIATION3 | — | AMERICAN FIDELITY ASSURANCE COMPANY | — | $104 | $104 | 1.35% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | P O BOX 100 EASTLAKE, CO 80614 | AMERICAN FIDELITY ASSURANCE COMPANY | $187 | — | $187 | 5.01% |
| CADA INSURANCE SERVICES INC3 | 290 SPEER BOULEVARD DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $112 | — | $112 | 3.00% |
| ASSURANCE AGENCY LTD Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $32 | — | $32 | 0.86% |
| CADA INSURANCE SERVICES INC3 | 290 SPEER BOULEVARD DENVER, CO 80203 | AMERICAN FIDELITY ASSURANCE COMPANY | $82 | — | $82 | 2.96% |
| ASSURANCE AGENCY LTD3 Filed as: AMERICAN FIDELITY ASSURANCE COMPANY | P. O. BOX 25360 OKLAHOMA CITY, OK 73125 | AMERICAN FIDELITY ASSURANCE COMPANY | $55 | — | $55 | 1.99% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 | P O BOX 100 EASTLAKE, CO 80614 | AMERICAN FIDELITY ASSURANCE COMPANY | $38 | — | $38 | 1.37% |
| COLORADO AUTO DEALERS ASSOCIATION3 | — | AMERICAN FIDELITY ASSURANCE COMPANY | — | $32 | $32 | 1.16% |
| MOUNTAINSIDE INSURANCE MANAGEMENT3 Filed as: MOUNTAINSIDE INSURANCE MANAGEMENT L | PO BOX 100 EASTLAKE, CO 80614 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $200 | — | $200 | 9.99% |
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 | 96 | 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) | 97 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 129 | $102K |
| Vision | EMBER ASSURANCE, INC. | 104 | $11K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 231 | $22K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 0 | $4K |
| Long-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 66 | $97K |
| Stop-loss / reinsurancereinsurance | HCC LIFE INSURANCE COMPANY | 97 | $663K |
| Other(6 contracts, 2 carriers) | AMERICAN FIDELITY ASSURANCE COMPANY | 231 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 231 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.