| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BRAD ROTHHAMMER3 | 5347 S VALENTIA WAY SUITE 130 GREENWOOD VILLAGE, CO 801113147 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 7.37% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOCIATION INC | 6200 S SYRACUSE STE 460 C/O CARRARA PLACE GREENWOOD VILLAGE, CO 801114760 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.58% |
| INS EXCHANGE LLC3 | 5 ROEHM CT WEST ORANGE, NJ 070523147 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.83% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES | 31110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 2.78% |
| CORPORATE BENEFIT DESIGN3 | 5347 S. VALENTIA WAY GREENWOOD VILLAGE, CO 80111 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $3K | — | $3K | 9.98% |
| BETA HEALTH ASSOCIATION3 | 6200 SOUTH SYRACUSE WAY GREENWOOD VILLAGE, CO 80111 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | $2K | — | $2K | 7.98% |
| CORPORATE BENEFIT DESIGN3 | 5347 S VALENTIA WAY STE 130 GREENWOOD VILLAGE, CO 80111 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.05% |
| BRADLEY ROTHHAMMER3 | 2405 CHERRYRIDGE RD ENGLEWOOD, CO 80110 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $711 | — | $711 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| LUCENT HEALTH EIN 39-1997579 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 5560 W. GRANDE MARKET DRIVE APPLETON, WI 54913 | $80K |
| CORPORATE BENEFIT DESIGN EIN 84-1489722 AGENT FEES | Insurance agents and brokers Service code 22 | 5347 S VALENTIA WAY, STE 300 GREENWOOD VILLAGE, CO 80111 | $55K |
| 6 DEGREES HEALTH DX LLC EIN 81-4242649 REF BASEPR | Other services Service code 49 | 5800 NE PINEFARM COURT, STE 200 HILLSBORO, OR 97124 | $36K |
| NARUS HEALTH INC. EIN 47-1929604 U/R & MAP | Other services Service code 49 | 424 CHURCH ST. STE 2300 NASHVILLE, TN 37219 | $24K |
| HEALTHEOS EIN 39-1634080 PPO CHARGE | Other services Service code 49 | PO BOX 29380 NEW YORK, NY 10087 | $8K |
| CAREOPERATIVE LLC EIN 46-4399706 HCBB & HCBB COMP | Other services Service code 49 | 330 FRANKLIN RD., STE. 135A-42B BRENTWOOD, TN 37027 | $1K |
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 | 220 | 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) | 220 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITED HEALTHCARE INSURANCE COMPANY | 220 | $14K |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 220 | $93K |
| Vision(2 contracts, 2 carriers) | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INSURANCE | 291 | $40K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $18K |
| Stop-loss / reinsurancereinsurance | PAN-AMERICAN LIFE INSURANCE COMPANY | 220 | $200K |
| Other(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 220 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.