| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COBIZ INSURANCE3 | 821 17TH STREET DENVER, CO 80202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.63% |
| COBIZ INSURANCE3 | 821 17TH STREET DENVER, CO 80202 | COMPREHENSIVE CARE SERVICES, INC. | $8K | — | $8K | 6.75% |
| COBIZ INSURANCE3 | 821 17TH ST. DENVER, CO 80202 | HARTFORD LIFE AND ACCIDENT | $6K | — | $6K | 15.00% |
| COBIZ INSURANCE3 | 821 17TH ST, DENVER, CO 80202 | UNION SECURITY INSURANCE COMPANY | $3K | $538 | $3K | 11.86% |
| COBIZ INSURANCE3 Filed as: COBIZ INSURANCE INC. | 821 17TH ST. SUITE 800 DENVER, CO 80202 | ALLSTATE WORKPLACE DIVISION | $1K | — | $1K | 9.87% |
| COBIZ INSURANCE3 | 821 17TH STREET DENVER, CO 80202 | KANSAS CITY LIFE INSURANCE COMPANY | $569 | — | $569 | 12.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMPREHENSIVE CARE SERVICES, INC. EIN 41-1427596 HEALTH INSURANCE PROVIDER | Insurance services Service code 23 | — | $40K |
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 HEALTH INSURANCE PROVIDER | Named fiduciary; Non-monetary compensation; Other services; Claims processing; Float revenue; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $20K |
| UNION SECURITY INSURANCE COMPANY EIN 81-0170040 ADMIN SERVICES - DENTAL | Claims processing; Other fees Service code 12 | — | $13K |
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 | 522 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 522 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 522 | $611K |
| Dental | UNION SECURITY INSURANCE COMPANY | 42 | $29K |
| Life insurance(2 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 399 | $47K |
| Short-term disability | HARTFORD LIFE AND ACCIDENT | 399 | $43K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 399 | $43K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 522 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.