| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $22K | — | $22K | 4.95% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INSURANCE & FINANCE | 4851 LBJ FREEWAY SUITE 100 DALLAS, TX 75244 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $12K | $12K | 2.64% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $9K | — | $9K | 2.03% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 8.31% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC INC | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | COMPANION LIFE INSURANCE COMPANY | $2K | — | $2K | 4.87% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COMPANION LIFE INSURANCE COMPANY | $576 | — | $576 | 1.43% |
| VOLUNTARY SOLUTIONS INC3 | 509 S 4TH AVE BRIGHTON, CO 80601 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $1K | $2K | 19.88% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 18.92% |
| RPM BENEFIT ADVISORS LLC3 Filed as: RPM BENEFITS ADVISORS LLC | 2997 HYDRA DR LOVELAND, CO 80537 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $696 | $373 | $1K | 9.92% |
| SELECTIVE OPTIONS INC3 | 9720 E 151ST PL BRIGHTON, CO 80602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $504 | $170 | $674 | 6.26% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $692 | $17 | $709 | 8.72% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $220 | — | $220 | 2.70% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $718 | $303 | $1K | 14.22% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LIFE INSURANCE COMPANY OF NORTH AMERICA | — | $466 | $466 | 6.49% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI MILLER BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | BETA HEALTH ASSOCIATION INC | $271 | — | $271 | 7.60% |
| 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 | $20K |
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 | 80 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 80 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 71 | $438K |
| Dental(2 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 42 | $44K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 80 | $8K |
| Life insurance(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 72 | $18K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 71 | $438K |
| Other(3 contracts, 3 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 74 | $11K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 80 | — |
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.