| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH STREET GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE CO. | $35K | — | $35K | 9.02% |
| CIGNA Filed as: CIGNA HEALTH AND LIFE INSURANCE CO | PO BOX 20643 LEHIGH VALLEY, PA 18002 | CIGNA HEALTH AND LIFE INSURANCE CO. | — | $31K | $31K | 8.20% |
| INTREPID3 Filed as: INTREPID BENEFITS, INC. | 707 17TH STREET, STE 3700 DENVER, CO 80202 | CIGNA HEALTH AND LIFE INSURANCE CO. | — | — | $0 | 0.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS | 8205 W 20TH STREET GREELEY, CO 80634 | COMPANION LIFE | $2K | — | $2K | 9.64% |
| BETA HEALTH ASSOCIATION Filed as: BETA HEALTH ASSOC INC | 9725 E HAMPDEN AVE DENVER, CO 80231 | COMPANION LIFE | $1K | — | $1K | 4.82% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH STREET GREELEY, CO 80634 | EYE MED (VISION) | $641 | — | $641 | 8.01% |
| SHIRAZI-MILLER BENEFITS LLC Filed as: SHIRAZI BENEFITS LLC | 5205 W 20TH STREET GREELEY, CO 80634 | BETA HEALTH | $1K | — | $1K | 14.25% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 | Named fiduciary; Direct payment from the plan; Non-monetary compensation; Contract Administrator; Participant communication; Other services; Float revenue; Claims processing Service code 12 | PO BOX 20643 LEHIGH VALLEY, PA 18002 | $5K |
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 | 186 | 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) | 186 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE CO. | 168 | $383K |
| Dental(2 contracts, 2 carriers) | COMPANION LIFE | 50 | $31K |
| Vision | EYE MED (VISION) | 142 | $8K |
| Life insurance | CIGNA HEALTH AND LIFE INSURANCE CO. | 168 | $383K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 168 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.