| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | CIGNA HEALTH & LIFE INS COMPANY | $54K | — | $54K | 9.86% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY | PO BOX 11506 PUEBLO, CO 81001 | CIGNA HEALTH & LIFE INS COMPANY | — | $21K | $21K | 3.93% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $15K | — | $15K | 6.81% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC | 9725 E HAMPDEN AVE STE 400 DENVER, CO 80231 | DELTA DENTAL OF COLORADO | $8K | — | $8K | 8.68% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | DELTA DENTAL OF COLORADO | $7K | — | $7K | 7.60% |
| GINA M WESOLEK3 | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $68 | $3K | 4.73% |
| RONALD VASQUEZ3 Filed as: RONALD N VASQUEZ | PO BOX 11506 PUEBLO, CO 81001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $529 | — | $529 | 0.86% |
| VICKY LYN SWANSON3 | 755 AMBERGLEN COURT COLORADO SPRINGS, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $239 | — | $239 | 0.39% |
| TERESA MARY ROBERSON3 | 711 CASTLE RD COLORADO SPRINGS, CO 80904 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $156 | $3 | $159 | 0.26% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $142 | — | $142 | 0.23% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS | 509 SOUTH 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $65 | $17 | $82 | 0.13% |
| MARY COAN3 | 119 ATHENA RD BLACK HAWK, CO 80422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $49 | $2 | $51 | 0.08% |
| BETA HEALTH ASSOCIATION3 | 9725 EAST HAMPDEN AVE SUITE 400 DENVER, CO 80231 | COMPANION LIFE | $2K | — | $2K | 6.74% |
| RONALD VASQUEZ3 | PO BOX 1156 PUEBLO, CO 81001 | COMPANION LIFE | $1K | — | $1K | 5.90% |
| RONALD VASQUEZ3 Filed as: RONALD VAZQUEZ | PO BOX 11506 PUEBLO, CO 81001 | BETA HEALTH ASSOCIATION, INC. | $910 | — | $910 | 6.65% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INS COMPANY EIN 59-1031071 SERVICE PROVIDER | Non-monetary compensation; Claims processing; Named fiduciary; Participant communication; Float revenue; Direct payment from the plan; Contract Administrator; Other services Service code 12 | — | $15K |
| CIGNA HEALTH & LIFE INS CO | Direct payment from the plan; Named fiduciary; Float revenue; Other services; Claims processing; Non-monetary compensation; Contract Administrator; Participant communication 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 | 229 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INS COMPANY | 197 | $543K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 225 | $104K |
| Vision | COMPANION LIFE | 143 | $24K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 294 | $280K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 294 | $218K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 294 | $218K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 294 | $218K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 294 | — |
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.