| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 | PO BOX 3207 BOSTON, MA 02241 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $102K | $1K | $103K | 1.09% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 6501 SOUTH FIDDLERS GREEN CIRCLE GREENWOOD VILLA, CO 80111 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $88K | — | $88K | 0.92% |
| LOCKTON COMPANIES, LLC3 | 2100 ROSS AVENUE, SUITE 1200 DALLAS, TX 75201 | METROPOLITAN LIFE INSURANCE COMPANY | $57K | $87 | $57K | 11.33% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 7050 ENGLEWOOD, CO 80155 | METROPOLITAN LIFE INSURANCE COMPANY | $19K | — | $19K | 3.89% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | METROPOLITAN LIFE INSURANCE COMPANY | — | $5K | $5K | 1.00% |
| LOCKTON COMPANIES, LLC3 | PO BOX 123042 DALLAS, TX 75312 | VISION SERVICE PLAN | $1K | — | $1K | 1.79% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 7050 ENGLEWOOD, CO 80155 | VISION SERVICE PLAN | $900 | — | $900 | 1.27% |
| THE M GROUP3 | UNKNOWN GREENWOOD VILLAGE, CO 80111 | SECURITY LIFE OF DENVER INSURANCE COMPANY | $2K | — | $2K | 6.29% |
| LAURA TALT3 | 2620 PECONIC AVENUE SEAFORD, NY 11783 | SECURITY LIFE OF DENVER INSURANCE COMPANY | $228 | — | $228 | 0.66% |
| LOCKTON COMPANIES, LLC3 | 1185 AVENUE OF THE AMERICAS SUITE 2010 NEW YORK, NY 10036 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| LAURA TALT3 Filed as: LAURA A. TALT | 2620 PECONIC AVENUE SEAFORD, NY 11783 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $8 | $3K | 26.16% |
| CRYSTAL IBC LLC3 Filed as: CRYSTAL AND COMPANY | 32 OLD SLIP NEW YORK, NY 10005 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $12 | — | $12 | 0.12% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 200 SUMMIT LAKE DRIVE, SUITE 350 VALHALLA, NY 10595 | HYATT LEGAL PLANS | $185 | — | $185 | 6.56% |
| LOCKTON COMPANIES, LLC3 | 717 NORTH HARWOOD, SUITE 2500 DALLAS, TX 75201 | HYATT LEGAL PLANS | $139 | — | $139 | 4.93% |
| LOCKTON COMPANIES, LLC3 | 444 WEST 47TH STREET, SUITE 900 KANSAS CITY, MO 64112 | HYATT LEGAL PLANS | — | $26 | $26 | 0.92% |
| LAURA TALT3 | 2620 PECONIC AVENUE SEAFORD, NY 11783 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $209 | — | $209 | 14.97% |
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 | 1,201 | 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) | 1,201 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 2,029 | $9.5M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 1,180 | $501K |
| Vision(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 2,029 | $9.6M |
| Life insurance(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,201 | $535K |
| Short-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,180 | $520K |
| Long-term disability(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 1,180 | $511K |
| Prescription drug | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 2,029 | $9.5M |
| Other(4 contracts, 4 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 2,029 | $10.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,029 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.