| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INC3 Filed as: GBS BENEFITS, INC | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $31K | — | $31K | 6.31% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY STREET 101 LONGMONT, CO 80501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $5K | — | $5K | 10.66% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY STREET 101 LONGMONT, CO 80501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | — | $4K | 10.00% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY STREET 101 LONGMONT, CO 80501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | — | VISION SERVICE PLAN | $2K | — | $2K | 9.99% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY STREET 101 LONGMONT, CO 80501 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $278 | — | $278 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 SERVICE PROVIDER | Contract Administrator; Named fiduciary; Claims processing Service code 12 | — | $141K |
| CIGNA | Named fiduciary; Contract Administrator; Direct payment from the plan; Claims processing; Non-monetary compensation; Other services; Float revenue; Participant communication Service code 12 | — | $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 | 174 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 174 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $497K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 151 | $497K |
| Vision | VISION SERVICE PLAN | 152 | $18K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 172 | $47K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 171 | $25K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 174 | $40K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 172 | $3K |
| 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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.