| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| REDWINE ROBERT3 | 503 N MAIN ST SUITE 314 PUEBLO, CO 81003 | SUN LIFE ASSURANCE COMPANY OF CANADA | $31K | — | $31K | 10.89% |
| EMERSON REID LLC3 | 1305 WALT WHITMAN RD SUITE 310 MELVILLE, NY 11747 | SUN LIFE ASSURANCE COMPANY OF CANADA | $15K | — | $15K | 5.44% |
| EMPLOYER ADVANTAGE INS LLC3 Filed as: EMPLOYER ADVANTAGE INSUSRANCE | 3632 E OAKVIEW DRIVE SALT LAKE CITY, UT 84124 | LIBERTY MUTUAL ASSURANCE CO OF BOSTON | $10K | — | $10K | 6.96% |
| EMPLOYER ADVANTAGE INS LLC3 Filed as: EMPLOYER ADVANTAGE INSURANCE | 3631 E OAKVIEW DRIVE SALT LAKE CITY, UT 84124 | LIBERTY MUTUAL ASSURANCE COMPANY OF BOSTON | $25K | — | $25K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| REGIONAL CARE INC EIN 47-0760050 TPA | Claims processing Service code 12 | 905 WEST 27TH STREET SCOTTSBLUFF, NE 69361 | $330K |
| DENTAL DENTAL OF COLORADO EIN 84-0568337 CLAIMS ADMIN | Contract Administrator Service code 13 | PO BOX 173803 DENVER, CO 802173803 | $94K |
| PUEBLO HEALTH CARE EIN 84-1508650 NETWORK | Insurance services Service code 23 | 400 WEST 16TH STREET PUEBLO, CO 81003 | $79K |
| MEDICAL COST MANAGEMENT CORP EIN 36-3445315 UR VENDOR | Insurance services Service code 23 | 200 WEST MONROE STREET SUITE 1850 CHICAGO, IL 60606 | $38K |
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 | 1,671 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 28 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 1,699 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Life insurance(2 contracts, 2 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 2,246 | $428K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 504 | $283K |
| Long-term disability | LIBERTY MUTUAL ASSURANCE COMPANY OF BOSTON | 1,518 | $0 |
| Stop-loss / reinsurancereinsurance | WESTPORT | 1,593 | $194K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,246 | — |
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.