| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES | PO BOX 11506 PUEBLO, CO 81001 | CIGNA HEALTH & LIFE INS COMPANY | $35K | — | $35K | 5.73% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | STE 700 80 SOUTH 8TH ST MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $5K | $17K | 6.16% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $5K | $5K | $11K | 7.88% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF DENVER | 1125 17TH ST STE 400 DENVER, CO 80202 | DELTA DENTAL OF COLORADO | $9K | — | $9K | 6.90% |
| GINA M WESOLEK3 | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | — | $4K | 5.28% |
| TERESA MARY ROBERSON3 | 711 CASTLE RD COLORADO SPRINGS, CO 80904 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.60% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP INC | 80 SOUTH 8TH STREET MINNEOPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $804 | $80 | $884 | 1.27% |
| MARY COAN3 | 119 ATHENA RD BLACK HAWK, CO 80422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $554 | — | $554 | 0.80% |
| VOLUNTARY SOLUTIONS INC3 | 509 SOUTH 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $308 | $188 | $496 | 0.71% |
| RONALD VASQUEZ3 Filed as: RONALD N VASQUEZ | PO BOX 11506 PUEBLO, CO 81001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $495 | — | $495 | 0.71% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES INC | 80 S 8TH STREET MINNEAPOLIS, MN 55402 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $190 | — | $190 | 0.27% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $134 | — | $134 | 0.19% |
| MELISSA A KOLL3 | 216 CLIMAX DRIVE DILLON, CO 80435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $50 | $2 | $52 | 0.07% |
| VICKY LYN SWANSON3 | 755 AMBERGLEN COURT COLORADO SPRINGS, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $33 | — | $33 | 0.05% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES, INC | 80 SOUTH 8TH ST STE 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $648 | $6K | 17.00% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC INC | 6200 S. SYRACUSE WAY SUITE 460 GREENWOOD VLG, CO 80111 | COMPANION LIFE | $2K | $10 | $2K | 7.63% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS COMPANY EIN 59-1031071 SERVICE PROVIDER | Claims processing; Non-monetary compensation; Direct payment from the plan; Float revenue; Contract Administrator; Participant communication; Named fiduciary; Other services Service code 12 | — | $453K |
| CIGNA | Other services; Participant communication; Contract Administrator; Claims processing; Float revenue; Named fiduciary; Non-monetary compensation; Direct payment from the plan Service code 12 | — | $0 |
| CIGNA HEALTH & LIFE INS CO | Float revenue; Claims processing; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Direct payment from the plan; Contract Administrator 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 & LIFE INS COMPANY | 224 | $612K |
| Dental | DELTA DENTAL OF COLORADO | 313 | $136K |
| Vision | COMPANION LIFE | 196 | $26K |
| Life insurance(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $373K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $271K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $271K |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 328 | $303K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 328 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.