| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF DENVER | 1125 17TH ST STE 400 DENVER, CO 80202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | — | $35K | 4.36% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $5K | $5K | 2.17% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF DENVER | 1125 17TH ST STE 400 DENVER, CO 80202 | DELTA DENTAL OF COLORADO | $9K | — | $9K | 6.40% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF DENVER | 1125 17TH ST STE 400 DENVER, CO 80202 | DELTA DENTAL OF COLORADO | $9K | — | $9K | 6.40% |
| BETA HEALTH ASSOCIATION3 | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $6K | — | $6K | 3.99% |
| BETA HEALTH ASSOCIATION3 | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $6K | — | $6K | 3.99% |
| BETA HEALTH ASSOCIATION3 | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $6K | — | $6K | 3.99% |
| BETA HEALTH ASSOCIATION3 | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $6K | — | $6K | 3.99% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF COLORADO | $829 | — | $829 | 0.59% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF COLORADO | $829 | — | $829 | 0.59% |
| GINA WESOLEK3 | 114 LAKE WOOD CIR WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | — | $3K | 4.31% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $162 | $2K | 2.21% |
| VOLUNTARY SOLUTIONS INC3 | 509 S 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $953 | $555 | $2K | 2.01% |
| VICKY LYN SWANSON3 | 755 AMBERGLEN CT COLORADO SPRINGS, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $854 | — | $854 | 1.14% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DR LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $794 | — | $794 | 1.06% |
| RONALD VASQUEZ3 Filed as: RONALD N VASQUEZ | PO BOX 11506 PUEBLO, CO 81001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $495 | — | $495 | 0.66% |
| KAITLYN VICTORIA BAUNE3 | 10701 DARNEAL DR FOUNTAIN, CO 80817 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $456 | — | $456 | 0.61% |
| EDWARD JOSEPH CORBETT3 | 6185 S PARIS ST GREENWOOD VILLAGE, CO 80111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $164 | $56 | $220 | 0.29% |
| TERESA MARY ROBERSON3 | 711 CASTLE RD COLORADO SPRINGS, CO 80904 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $209 | — | $209 | 0.28% |
| MARY COAN3 | 119 ATHENA RD BLACK HAWK, CO 80422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $104 | — | $104 | 0.14% |
| MELISSA A KOLL3 | 216 CLIMAX DR DILLON, CO 80435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $27 | — | $27 | 0.04% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | COMPANION LIFE INSURANCE COMPANY | — | $3K | $3K | 8.79% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2 | $557 | $559 | 2.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE CO EIN 59-1031071 CLAIM PROCESSOR | Non-monetary compensation; Float revenue; Participant communication; Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Other services Service code 12 | — | $28K |
| CIGNA | Other services; Contract Administrator; Direct payment from the plan; Claims processing; Named fiduciary; Float revenue; Participant communication; Non-monetary compensation 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 | 262 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 214 | $806K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 321 | $151K |
| Vision | COMPANION LIFE INSURANCE COMPANY | 189 | $29K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 311 | $347K |
| Short-term disability(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 311 | $321K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 311 | $247K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 311 | $347K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 321 | — |
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.