| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FLOOD & PETERSON BENEFITS LLC3 Filed as: FLOOD & PETERSON BENEFITS | PO BOX 578 GREELEY, CO 80632 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $103K | — | $103K | 15.00% |
| FLOOD & PETERSON BENEFITS LLC3 Filed as: FLOOD & PETERSON BENEFITS | PO BOX 578 GREELEY, CO 80632 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $130K | — | $130K | 20.01% |
| THE BOON INSURANCE AGENCY3 | 6300 BRIDGEPOINT PARKWAY SUITE 500 AUSTIN, TX 78730 | TRANSAMERICA LIFE INSURANCE COMPANY | $29K | — | $29K | 10.00% |
| FLOOD & PETERSON BENEFITS LLC3 Filed as: FLOOD & PETERSON BENEFITS | PO BOX 578 GREELEY, CO 80632 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $13K | — | $13K | 15.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Named fiduciary; Participant communication; Direct payment from the plan; Contract Administrator; Claims processing; Non-monetary compensation; Float revenue; Other services Service code 12 | — | $2.3M |
| BOON ADMINISTRATIVE SERVICES, INC. EIN 33-0449333 NONE | Other insurance fees and expenses; Claims processing; Contract Administrator Service code 12 | — | $402K |
| FLOOD & PETERSON INSURANCE, INC. EIN 20-0899501 NONE | Insurance agents and brokers Service code 22 | — | $70K |
| WITHUMSMITH+BROWN, PC EIN 22-2027092 NONE | Accounting (including auditing) Service code 10 | — | $26K |
| COMERICA BANK EIN 38-1998421 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $6K |
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 | 3,040 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 49 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 3,089 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,757 | $1.4M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 1,757 | $1.4M |
| Life insurance(2 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,600 | $971K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 239 | $42K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 2,520 | $648K |
| Other(2 contracts, 2 carriers) | TRANSAMERICA LIFE INSURANCE COMPANY | 2,600 | $376K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,600 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.