| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $38K | — | $38K | 8.26% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCE | 4851 LBJ FREEWAY SUITE 100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $19K | $19K | 4.04% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 9.65% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC INC | 9725 E HAMPDEN AVE 400 DENVER, CO 80231 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 4.82% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $1K | $3 | $1K | 11.04% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $888 | $178 | $1K | 12.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | BETA HEALTH ASSOCIATION INC | $1K | — | $1K | 14.24% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 NONE | Contract Administrator Service code 13 | 900 COTTAGE GROVE BLOOMFIELD, CT 06002 | $8K |
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 | 92 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $464K |
| Dental(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 45 | $52K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 93 | $10K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 91 | $9K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 92 | $464K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 91 | $9K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 93 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.