| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DELTA DENTAL OF COLORADO5 | P.O. BOX 173803 DENVER, CO 80217 | DELTA DENTAL OF COLORADO | — | — | $0 | 0.00% |
| IMA, INC.3 | P.O. BOX 2992 WICHITA, KS 67201 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 1.38% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AMERIBEN/IEC GROUP EIN 84-1348907 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $203K |
| PARTNERS RX MANAGEMENT LLC EIN 86-1042036 PHARMACY BENEFIT MGMT | Direct payment from the plan; Other fees; Claims processing Service code 12 | — | $51K |
| DELTA DENTAL OF COLORADO EIN 84-0568337 DENTAL CLAIMS ADMIN | Contract Administrator Service code 13 | P.O. BOX 173803 DENVER, CO 802173803 | $30K |
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 | 622 | 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) | 622 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF COLORADO | 1,454 | $396K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 1,048 | $57K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 899 | $369K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 899 | $293K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 899 | $293K |
| Stop-loss / reinsurancereinsurance | AETNA LIFE INSURANCE COMPANY AND AFFILIATES | 620 | $666K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 899 | $384K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,454 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.