| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | CIGNA HEALTH & LIFE INS COMPANY | $46K | — | $46K | 11.07% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY | — | CIGNA HEALTH & LIFE INS COMPANY | — | $18K | $18K | 4.41% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $14K | — | $14K | 8.28% |
| GINA WESOLEK3 | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $809 | $6K | 7.01% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $978 | — | $978 | 1.08% |
| VICKY LYN SWANSON3 | 755 AMBERGLEN COURT COLORADO SPRINGS, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $554 | $67 | $621 | 0.69% |
| KRISTEN ELISE RANDALL3 | 9538 WEST SAN JUAN CIR LITTLETON, CO 80128 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $265 | $2 | $267 | 0.30% |
| VOLUNTARY SOLUTIONS INC3 | 195 TELLURIDE ST BRIGHTON, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $74 | — | $74 | 0.08% |
| RON SWANSON3 | 755 AMBERGLEN CT COLORADO SPRINGS, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $20 | — | $20 | 0.02% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | DELTA DENTAL OF COLORADO | $4K | — | $4K | 6.21% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC | 9725 E HAMPDEN AVE STE 400 DENVER, CO 80231 | DELTA DENTAL OF COLORADO | $2K | — | $2K | 3.55% |
| BETA HEALTH ASSOCIATION3 | 9725 EAST HAMPDEN AVE SUITE 400 DENVER, CO 80231 | COMPANION LIFE | $2K | — | $2K | 9.12% |
| RONALD VASQUEZ3 | PO BOX 1156 PUEBLO, CO 81001 | COMPANION LIFE | $1K | — | $1K | 6.79% |
| RONALD VASQUEZ3 Filed as: RONALD VAZQUEZ | PO BOX 11506 PUEBLO, CO 81001 | BETA HEALTH ASSOCIATION, INC. | $998 | — | $998 | 6.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS COMPANY EIN 59-1031071 CARRIER | Participant communication; Float revenue; Other services; Non-monetary compensation; Direct payment from the plan; Contract Administrator; Claims processing; Named fiduciary Service code 12 | — | $9K |
| CIGNA HEALTH & LIFE INS CO | Participant communication; Named fiduciary; Float revenue; Claims processing; Contract Administrator; Direct payment from the plan; Other services; 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 | 222 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 222 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INS COMPANY | 180 | $416K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 199 | $83K |
| Vision | COMPANION LIFE | 129 | $17K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $255K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $164K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $164K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 277 | $164K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 277 | — |
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.