| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | 155 INVERNESS DRIVE W ENGLEWOOD, CO 80112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $5K | $632 | $6K | 11.10% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | DBA CCIG 155 INVERNESS DRIVE W ENGLEWOOD, CO 80112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.00% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | DBA CCIG 155 INVERNESS DR W STE 800 ENGLEWOOD, CO 80112 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
| EMPLOYEE NAVIGATOR, LLC3 | 7979 OLD GEORGETOWN RD STE 300 BETHESDA, MD 208142554 | VISION SERVICE PLAN | $29 | — | $29 | 0.21% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | DBA CCIG 155 INVERNESS DRIVE W ENGLEWOOD, CO 80112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $458 | — | $458 | 10.00% |
| CHERRY CREEK BENEFITS3 Filed as: CHERRY CREEK INSURANCE AGENCY | DBA CCIG 155 INVERNESS DRIVE W ENGLEWOOD, CO 80112 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $141 | — | $141 | 10.01% |
No Schedule C service providers reported on this filing.
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 122 | $399K |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 83 | $52K |
| Vision | VISION SERVICE PLAN | 71 | $14K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $5K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 95 | $18K |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 113 | $1K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 122 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.