| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 W 20TH STREET STE. A GREELEY, CO 80631 | COMPANION LIFE INSURANCE COMPANY | $5K | — | $5K | 10.61% |
| BETA HEALTH ASSOCIATION3 Filed as: BETA HEALTH ASSOC. INC. | 6200 S SYRACUSE WAY STE 460 GREENWOOD VILLAGE, CO 80111 | COMPANION LIFE INSURANCE COMPANY | $3K | — | $3K | 5.30% |
| SHIRAZI-MILLER BENEFITS LLC3 | 8205 W 20TH STREET GREELEY, CO 80634 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 15.00% |
| AXA ASSISTANCE, USA5 Filed as: AXA ASSISTANCE USA | 122 S MICHIGAN AVE STE 1100 CHICAGO, IL 60603 | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $67 | $67 | 0.67% |
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 | 172 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 172 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INSURANCE COMPANY | 98 | $52K |
| Life insurance | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 171 | $10K |
| Long-term disability | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 171 | $10K |
| Other | THE PRUDENTIAL INSURANCE COMPANY OF AMERICA | 171 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 171 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.