| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC | 8055 E. TUFTS AVE STE 1000 DENVER, CO 80237 | BLUE CROSS BLUE SHIELD OF KANSAS | $29K | — | $29K | 3.99% |
| GROUP BENEFITS SERVICES LLC3 | 8055 E TUFTS AVE STE 1000 DENVER, CO 80237 | UNION SECURITY INSURANCE COMPANY | $15K | $7K | $22K | 13.67% |
| MOODY INSURANCE AGENCY3 Filed as: MOODY INSURANCE AGENCY INC | 8055 E TUFTS AVE STE 1000 DENVER, CO 802370000 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $993 | — | $993 | 5.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 INSURANCE BROKER | Participant communication; Named fiduciary; Non-monetary compensation; Float revenue; Other services; Claims processing; Contract Administrator; Direct payment from the plan Service code 12 | — | $230K |
| GROUP BENEFIT SERVICES LLC INSURANCE BROKER | Insurance brokerage commissions and fees Service code 53 | 8055 EAST TUFTS AVENUE, STE 1000 DENVER, CO 80237 | $80K |
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 | Other fees; Claims processing Service code 12 | — | $19K |
| MOODY INSURANCE INSURANCE BROKER | Insurance agents and brokers; Other commissions Service code 22 | 8055 EAST TUFTS AVENUE, STE 1000 DENVER, CO 80237 | $10K |
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 | 754 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 756 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF KANSAS | 233 | $724K |
| Vision | UNION SECURITY INSURANCE COMPANY | 754 | $158K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 282 | $20K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 754 | $158K |
| Long-term disability | UNION SECURITY INSURANCE COMPANY | 754 | $158K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF KANSAS | 233 | $724K |
| Other | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 282 | $20K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 754 | — |
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.