| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $21K | — | $21K | 6.17% |
| USI INSURANCE SERVICES LLC3 Filed as: USI COLORADO LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $15K | — | $15K | 4.30% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INS. AGENCY | 155 INVERNESS DR W ENGLEWOOD, CO 80112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $601 | $601 | 0.17% |
| VOLUNTARY SOLUTIONS INC3 | 509 SOUTH 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $13K | $7K | $20K | 14.30% |
| RPM BENEFIT ADVISORS LLC3 | 2997 HYDRA DR LOVELAND, CO 80537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $5K | $1K | $6K | 4.53% |
| SELECTIVE OPTIONS INC3 | 9720 E 151ST PLACE BRIGHTON, CO 80602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | $308 | $2K | 1.40% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC. | 6200 SOUTH SYRACUSE WAY GREENWOOD VILLAGE, CO 80111 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $504 | — | $504 | 0.36% |
| MELISSA A KOLL3 | 216 CLIMAX DR DILLON, CO 80435 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $298 | — | $298 | 0.21% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $2K | — | $2K | 4.75% |
| USI INSURANCE SERVICES LLC3 Filed as: USI COLORADO LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $982 | — | $982 | 2.35% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INS. AGENCY | 155 INVERNESS DR W ENGLEWOOD, CO 80112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | -$1 | $601 | $600 | 1.43% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 234662817 | VISION SERVICE PLAN | $553 | — | $553 | 4.77% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES NATIONAL INC | PO BOX 202914 GREENWOOD VILLAGE, CO 80111 | VISION SERVICE PLAN | $265 | — | $265 | 2.29% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 12.59% |
| USI INSURANCE SERVICES LLC3 | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA DENTAL HEALTH OF COLORADO, INC | $208 | — | $208 | 6.83% |
| USI INSURANCE SERVICES LLC3 Filed as: USI COLORADO LLC | PO BOX 62817 VIRGINIA BEACH, VA 23466 | CIGNA DENTAL HEALTH OF COLORADO, INC | $98 | — | $98 | 3.22% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY INC | 155 INVERNESS DR W ENGLEWOOD, CO 80112 | CIGNA DENTAL HEALTH OF COLORADO, INC | -$1 | — | -$1 | -0.03% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 | Claims processing; Float revenue; Other services; Participant communication; Insurance agents and brokers; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Named fiduciary Service code 12 | — | $16K |
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 | 118 | Currently employed and enrolled or eligible. |
| Retired/separated still eligible | 12 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 130 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 149 | $345K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 114 | $45K |
| Vision | VISION SERVICE PLAN | 117 | $12K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 133 | $150K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 118 | $25K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 133 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 149 | — |
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.