| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES INC. | 353 NORTH CLARK STREET CHICAGO, IL 60654 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $32K | — | $32K | 3.58% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 4600 SOUTH SYRACUSE STREET SUITE 1250 DENVER, CO 80237 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | — | $10K | $10K | 1.10% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICES, INC. | 353 NORTH CLARK STREET CHICAGO, IL 60654 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $580 | — | $580 | 6.48% |
| ELIZABETH B FINEBERG3 | 549 WAGON BEND ROAD BERTHOUD, CO 80513 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $401 | — | $401 | 4.48% |
| SCOTT ROBERT STORJOHANN3 Filed as: SCOTT R STORJOHANN | 10110 EATON STREET WESTMINISTER, CO 80020 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $140 | — | $140 | 1.56% |
| LARRY W NICHOLSON3 Filed as: LARRY NICHOLSON | 861 NORTH AUBURNDALE STREET MEMPHIS, TN 38107 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $83 | — | $83 | 0.93% |
| DONNA BONNE3 | 88 WEST MAPLE AVENUE DENVER, CO 80223 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $79 | — | $79 | 0.88% |
| KATHERINE ANDERSON3 Filed as: KATHERINE S KEAST-ANDERSON | 2050 EAST 101ST COURT THORNTON, CO 80239 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $21 | — | $21 | 0.23% |
| KRISTIE A LEATHERS3 | 2143 RANCH DRIVE WESTMINSTER, CO 80234 | CONTINENTAL AMERICAN LIFE INSURANCE COMPANY | $1 | — | $1 | 0.01% |
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 | 214 | 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) | 214 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 127 | $893K |
| Dental | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 127 | $893K |
| Vision | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 127 | $893K |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 214 | $38K |
| Other(2 contracts, 2 carriers) | ANTHEM LIFE INSURANCE COMPANY | 214 | $47K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 214 | — |
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.