| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| MESIROW INSURANCE SERVICES INC3 | 353 NORTH CLARK STREET CHICAGO, IL 60610 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 1.03% |
| SCOTT ROBERT STORJOHANN3 | 10110 EATON ST WESTMINSTER, CO 80020 | CONTINENTAL AMERICAN INSURANCE COMPANY | $849 | — | $849 | 0.64% |
| JAMES J SCHAMBER3 Filed as: JAMES S SCHAMBER | 6000 E EVANS AVE BUILDING 1, SUITE 300 DENVER, CO 80222 | CONTINENTAL AMERICAN INSURANCE COMPANY | $111 | — | $111 | 0.08% |
| ELIZABETH B FINEBERG3 Filed as: ELIZABETH FINEBERG | 549 WAGON BEND RD BERTHOUD, CO 805132690 | CONTINENTAL AMERICAN INSURANCE COMPANY | $95 | — | $95 | 0.07% |
| DONNA BONNE3 | 88 W MAPLE AVE DENVER, CO 802231839 | CONTINENTAL AMERICAN INSURANCE COMPANY | $57 | — | $57 | 0.04% |
| KATHERINE S ANDERSON3 | 3853 BUENA VISTA DR LOVELAND, CO 80538 | CONTINENTAL AMERICAN INSURANCE COMPANY | $29 | — | $29 | 0.02% |
| ZENAT SHARIFF BELKIN3 Filed as: ZENAT S BELKIN | 14204 W EVANS CIR LAKEWOOD, CO 80228 | CONTINENTAL AMERICAN INSURANCE COMPANY | $27 | — | $27 | 0.02% |
| LARRY W NICHOLSON JR3 | 1331 W MOREHEAD ST 115 CHARLOTTE, NC 28208 | CONTINENTAL AMERICAN INSURANCE COMPANY | $2 | — | $2 | 0.00% |
| MESIROW INSURANCE SERVICES INC3 | 321 N CLARK, 11ST FL CHICAGO, IL 60611 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | $636 | $6K | 6.45% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERVICES INC | 32110 AGOURA RD WESTLAKE VILLAGE, CA 913614026 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $0 | $2K | $2K | 2.28% |
| COTTINGHAM & BUTLER3 Filed as: COTTINGHAM & BUTLER INSURANCE SERV | 800 MAIN STREET DUBUQUE, IA 52001 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 2.10% |
| MESIROW INSURANCE SERVICES INC3 Filed as: MESIROW INSURANCE SERVICE 429604 | 353 N CLARK ST STE 1100 CHICAGO, IL 60610 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $12K | $12 | $12K | 100.10% |
| BENEFITMALL3 Filed as: BENEFITMALL 018229 | 4643 S ULSTER ST STE 200 DENVER, CO 80237 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $6K | $6K | 50.00% |
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 | 280 | 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) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 174 | $98K |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 174 | $98K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 263 | $12K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 263 | $12K |
| Other(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 263 | $145K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 263 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.