| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| LOCKTON COMPANIES, LLC3 Filed as: LOCKTON COMPANIES LLC | 8110 EAST UNION AVENUE, SUIE 700 DENVER, CO 80237 | UNITEDHEALTHCARE INSURANCE COMPANY | $40K | $0 | $40K | 1.72% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SVCS., INC. | 2000 SOUTH COLORADO BOULEVARD SUITE 150 DENVER, CO 80222 | UNITEDHEALTHCARE INSURANCE COMPANY | $40K | $0 | $40K | 1.72% |
| LOCKTON COMPANIES, LLC3 | PO BOX 173850 DENVER, CO 80217 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $1K | $9K | 5.41% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL | 1125 17TH STREET, SUITE 900 DENVER, CO 80202 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $7K | $0 | $7K | 4.56% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INS. SERVICES | 111 SOUTH TEJON STREET, SUITE 113 COLORADO SPRINGS, CO 80903 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $1K | $1K | 0.70% |
| PLANSOURCE BENEFITS ADMINISTRATION3 Filed as: PLANSOURCE BENEFIT ADMINSTRATION | PO BOX 1313 ORLANDO, FL 32802 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $808 | $0 | $808 | 0.50% |
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 | 260 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 22 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 283 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 433 | $2.3M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 433 | $2.3M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY INSURANCE CO. | 379 | $23K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $162K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $162K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 260 | $162K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 433 | — |
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.