| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY STREET STE 101 LONGMONT, CO 80501 | ANTHEM LIFE INSURANCE COMPANY | $11K | — | $11K | — |
| MIA CORP3 | 18433 W 94TH LANE ARVADA, CO 80007 | ANTHEM LIFE INSURANCE COMPANY | $5K | — | $5K | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROCKY MOUNTAIN HOSPITAL AND MEDICAL EIN 84-0747736 UNKNOWN | Claims processing; Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other services Service code 12 | — | $3K |
| CIGNA EIN 59-1031071 CLAIM PROCESSOR | Direct payment from the plan; Named fiduciary; Participant communication; Other services; Non-monetary compensation; Claims processing; Float revenue; Contract Administrator Service code 12 | — | $32 |
| GBS COLORADO LLC EIN 84-0747736 UNKNOWN | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| MIA CORP EIN 47-2482907 UNKNOWN | Other commissions; Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $0 |
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 | 198 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 198 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | ANTHEM LIFE INSURANCE COMPANY | 174 | $0 |
| Vision | ANTHEM LIFE INSURANCE COMPANY | 174 | $0 |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 174 | $0 |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 174 | $0 |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 174 | $0 |
| Stop-loss / reinsurancereinsurance | ANTHEM LIFE INSURANCE COMPANY | 174 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 174 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.