| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| USI INSURANCE SERVICES LLC Filed as: USI INSURANCE SERVICES, LLC | UNKNOWN DENVER, CO 80216 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $0 | $0 | $0 | 0.00% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INSURANCE | PO BOX 202914 DALLAS, TX 753202914 | VISION SERVICE PLAN | $934 | $0 | $934 | 6.16% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | 1700 LINCOLN STREET, 9TH FLOOR DENVER, CO 80203 | ANTHEM LIFE INSURANCE COMPANY | $53K | $0 | $53K | — |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES, LLC | PO BOX 203417 DALLAS, TX 75320 | ANTHEM LIFE INSURANCE COMPANY | $0 | $3K | $3K | — |
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 | 208 | 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) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM LIFE INSURANCE COMPANY | 208 | $0 |
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 113 | $84K |
| Vision | VISION SERVICE PLAN | 89 | $15K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 208 | $0 |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 208 | $0 |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 208 | $0 |
| Prescription drug | ANTHEM LIFE INSURANCE COMPANY | 208 | $0 |
| Other | ANTHEM LIFE INSURANCE COMPANY | 208 | $0 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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.