| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COBIZ INSURANCE3 | 821 17TH STREET STE 800 DENVER, CO 80202 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $35K | — | $35K | 12.63% |
| COBIZ INSURANCE3 Filed as: COBIZ INSURANCE INC. | 821 17TH ST. 8TH FL DENVER, CO 80202 | DELTA DENTAL OF COLORADO | $4K | — | $4K | 4.98% |
| COBIZ INSURANCE3 Filed as: COBIZ INSURANCE INC. | 821 17TH STREET 8TH FLOOR DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 15.00% |
| COBIZ INSURANCE3 Filed as: COBIZ INSURANCE INC. | 821 17TH STREET 8TH FLOOR DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.19% |
| COBIZ INSURANCE3 Filed as: COBIZ INSURANCE INC. | 821 17TH STREET 8TH FLOOR DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 15.98% |
| COBIZ INSURANCE3 | 1401 LAWRENCE ST. SUITE 1200 DENVER, CO 80202 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| COBIZ INSURANCE3 Filed as: COBIZ INSURANCE INC. | 821 17TH STREET, 8TH FLOOR DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | — | $6K | 43.43% |
| CHRISTOPHER SMITH THOMAS3 | PO BOX 6650 MATAIRIE, TN 70009 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $237 | $3K | 20.34% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO. EIN 59-1031071 PLAN ADMINISTRATOR | Other services; Non-monetary compensation; Claims processing; Participant communication; Direct payment from the plan; Named fiduciary; Contract Administrator; Float revenue Service code 12 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CA 06002 | $12K |
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 | 241 | 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) | 241 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 0 | $281K |
| Dental | DELTA DENTAL OF COLORADO | 241 | $83K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 0 | $17K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $72K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $52K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 16 | $27K |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.