| 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 | $35K | — | $35K | 7.77% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCE | 4851 LBJ FREEWAY SUITE 100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $13K | $13K | 2.94% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 9.91% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC INC | 6200 S SYRACUSE WAY STE 460 GREENWOOD VLG, CO 80111 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 4.95% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $828 | $5 | $833 | 7.24% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $794 | $159 | $953 | 12.01% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | BETA HEALTH ASSOCIATION INC | $792 | — | $792 | 14.25% |
| 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 | $9K |
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 | 82 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 82 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 82 | $450K |
| Dental(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 45 | $49K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 88 | $12K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 86 | $8K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 82 | $450K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 86 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 88 | — |
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.