| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | CIGNA HEALTH & LIFE INS COMPANY | $25K | — | $25K | 4.35% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS AGCY | PO BOX 11506 PUEBLO, CO 81001 | CIGNA HEALTH & LIFE INS COMPANY | $23K | — | $23K | 4.00% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF DENVER | 1125 17TH ST. STE 400 DENVER, CO 80202 | CIGNA HEALTH & LIFE INS COMPANY | $8K | — | $8K | 1.48% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $137K | — | $137K | 54.16% |
| HAYS COMPANIES, INC.3 Filed as: HAYS BENEFITS GROUP, LLC | 80 S. 8TH ST. STE 700 MINIAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $1K | $3K | 1.24% |
| RONALD VASQUEZ3 | PO BOX 11506 PUEBLO, CO 81001 | DELTA DENTAL OF COLORADO | $7K | — | $7K | 6.11% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC | 9725 E HAMPDEN AVE STE 400 DENVER, CO 80231 | DELTA DENTAL OF COLORADO | $5K | — | $5K | 4.17% |
| HAYS COMPANIES, INC.3 Filed as: HAYS COMPANIES OF DENVER | 1125 17TH ST. STE 400 DENVER, CO 80202 | DELTA DENTAL OF COLORADO | $1K | — | $1K | 1.18% |
| MELISSA A KOLL3 | 216 CLIMAX DRIVE DILLON, CO 80435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $4K | $82 | $4K | 6.21% |
| GINA M WESOLEK3 | 114 LAKE WOOD CIRCLE WOODLAND PARK, CO 80863 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $3K | $27 | $3K | 4.23% |
| RONALD VASQUEZ3 Filed as: RONALD N VASQUEZ | PO BOX 11506 PUEBLO, CO 81001 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $552 | — | $552 | 0.81% |
| VICKY LYN SWANSON3 | 755 AMBERGLEN COURT COLORADO SPRINGS, CO 80906 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $212 | — | $212 | 0.31% |
| KRISTEN ELISE RANDALL3 | 22 S GAY DRIVE LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $148 | — | $148 | 0.22% |
| VOLUNTARY SOLUTIONS INC3 Filed as: VOLUNTARY SOLUTIONS, INC. | 509 S. 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $89 | $38 | $127 | 0.19% |
| MARY COAN3 | 119 ATHENA RD BLACK HAWK, CO 80422 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $102 | — | $102 | 0.15% |
| TERESA MARY ROBERSON3 | 711 CASTLE RD COLORADO SPRINGS, CO 80904 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $30 | — | $30 | 0.04% |
| BETA HEALTH ASSOCIATION3 | 6200 S. SYRACUSE WAY SUITE 460 GREENWOOD VLG, CO 80111 | COMPANION LIFE | $2K | $16 | $2K | 8.49% |
| RONALD VASQUEZ3 | PO BOX 1156 PUEBLO, CO 81001 | COMPANION LIFE | $2K | — | $2K | 7.37% |
| RONALD VASQUEZ3 Filed as: RONALD VAZQUEZ | PO BOX 11506 PUEBLO, CO 81001 | BETA HEALTH ASSOCIATION, INC. | $1K | — | $1K | 7.60% |
| 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 | — | $72K |
| CIGNA HEALTH & LIFE INS CO | Float revenue; Named fiduciary; Claims processing; Contract Administrator; Direct payment from the plan; Non-monetary compensation; Other services; 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 | 244 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 244 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH & LIFE INS COMPANY | 265 | $569K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 275 | $130K |
| Vision | COMPANION LIFE | 169 | $25K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $321K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $253K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $253K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 406 | $253K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 406 | — |
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.