| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CYPRESS BENEFIT ADMINISTRATORS, LLC3 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | HM INSURANCE GROUP | $15K | — | $15K | 4.32% |
| BETA HEALTH ASSOCIATION3 | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | DELTA DENTAL OF COLORADO | $2K | $2K | $4K | 7.70% |
| CORPORATE BENEFIT DESIGN3 Filed as: CORPORATE BENEFIT DESIGN LLC | 5347 S VALENTIA WAY SUITE 300 ENGLEWOOD, CO 80111 | DELTA DENTAL OF COLORADO | $3K | — | $3K | 6.74% |
| CYPRESS BENEFIT ADMINISTRATORS, LLC3 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | MEDICAL EXCESS INS REVIEW | — | — | $0 | 0.00% |
| CORPORATE BENEFIT DESIGN3 | 5347 S VALENTIA WAY STE 130 GREENWOOD VILLAGE, CO 80111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| CORPORATE BENEFIT DESIGN3 | 5347 S. VALENTIA WAY GREENWOOD VILLAGE, CO 80111 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $964 | — | $964 | 5.57% |
| BETA HEALTH ASSOCIATION3 | 9725 E. HAMPDEN AVE. STE. 400 DENVER, CO 80231 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $681 | — | $681 | 3.93% |
| BETA HEALTH ASSOCIATION3 | 6200 SOUTH SYRACUSE WAY GREENWOOD VILLAGE, CO 80111 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $60 | — | $60 | 0.35% |
| BETA HEALTH ASSOCIATION3 | 5575 TECH CENTER DRIVE DENVER, CO 80919 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $16 | — | $16 | 0.09% |
| BRADLEY ROTHHAMMER3 | 6455 S YOSEMITE # 300 ENGLEWOOD, CO 80111 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $974 | — | $974 | 9.15% |
| V.W. ALLABASHI & ASSOCIATES, LLC3 Filed as: V.W. ALLABASHI & ASSOC LLC | 6851 SOUTH HOLLY CRC ENGLEWOOD, CO 80112 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $19 | — | $19 | 0.18% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CORPORATE BENEFIT DESIGN EIN 84-1489722 INSURANCE AGENT | Custodial (securities) Service code 19 | 5347 S VALENTIN WAY SUITE 200 GREENWOOD VILLAGE, CO 80111 | $59K |
| CYPRESS BENEFIT ADMINISTRATORS, LLC EIN 39-1997579 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | $49K |
| CONNECTICUT GENERAL LIFE INS EIN 06-0303370 OTHER | Other fees Service code 99 | PO BOX 645014 CINCINNATI, OH 452645014 | $36K |
| PLANSOURCE BENEFITS ADMIN EIN 55-0800751 OTHER | Other fees Service code 99 | 101 S GARLAND AVE SUITE 203 ORLANDO, FL 32801 | $16K |
| WARNER PACIFIC INS SERVICE EIN 95-3959252 INSURANCE AGENT | Custodial (securities) Service code 19 | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | $2K |
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 | 318 | 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) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HM INSURANCE GROUP | 199 | $352K |
| Dental(2 contracts, 2 carriers) | DELTA DENTAL OF COLORADO | 126 | $59K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 190 | $17K |
| Life insurance(2 contracts, 2 carriers) | HM INSURANCE GROUP | 318 | $371K |
| Prescription drug | HM INSURANCE GROUP | 199 | $352K |
| Other(2 contracts, 2 carriers) | HM INSURANCE GROUP | 199 | $374K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 318 | — |
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.