| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DIGITAL INSURANCE LLC3 | 9781 S MERIDIAN BLVD STE 110 ENGLEWOOD, CO 80112 | SYMETRA LIFE INSURANCE COMPANY | $46K | — | $46K | 4.00% |
| DIGITAL INSURANCE LLC3 | 9781 S. MERIDIAN BLVD STE 110 ENGLEWOOD, CO 80112 | SYMETRA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Participant communication; Direct payment from the plan; Non-monetary compensation; Claims processing; Contract Administrator; Other services; Float revenue Service code 12 | — | $295K |
| COMPUSYS OF COLORADO EIN 84-0721304 NONE | Plan Administrator; Direct payment from the plan Service code 14 | — | $124K |
| SPENCER FANE LLP EIN 44-0561981 NONE | Legal; Direct payment from the plan Service code 29 | — | $56K |
| BHA CONSULTING LLC EIN 26-1384808 NONE | Consulting (general); Direct payment from the plan Service code 16 | — | $29K |
| NEEDLES & ASSOCIATES, LLC EIN 51-0435869 NONE | Direct payment from the plan; Accounting (including auditing) Service code 10 | — | $28K |
| MCMORGAN & COMPANY LLC EIN 52-2334338 NONE | Investment advisory (plan); Direct payment from the plan; Investment management Service code 27 | — | $16K |
| CIGNA | Non-monetary compensation; Float revenue; Claims processing; Other services; Contract Administrator; Direct payment from the plan; Participant communication; 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 | 440 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 16 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 456 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,086 | $18K |
| Life insurance | SYMETRA LIFE INSURANCE COMPANY | 545 | $42K |
| Stop-loss / reinsurancereinsurance | SYMETRA LIFE INSURANCE COMPANY | 463 | $1.2M |
| Other | SYMETRA LIFE INSURANCE COMPANY | 545 | $42K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,086 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.