| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA GROUP INSURANCE - MEDICAL | $73K | — | $73K | 16.18% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA GROUP INSURANCE -DENTAL | $12K | — | $12K | 9.85% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA GROUP INSURANCE - LTD | $6K | — | $6K | 10.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | VISION SERVICE PLAN | $1K | — | $1K | 4.90% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA GROUP INSURANCE - BASIC LIFE | $2K | — | $2K | 10.00% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI BENEFITS LLC | 8205 W 20TH ST GREELEY, CO 80634 | CIGNA GROUP INSURANCE - ACCIDENTAL DEATH | $301 | — | $301 | 9.99% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSUR CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Non-monetary compensation; Claims processing; Other services; Float revenue; Named fiduciary; Participant communication; Contract Administrator; Direct payment from the plan Service code 12 | — | $77K |
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 | 251 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 252 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CIGNA GROUP INSURANCE - MEDICAL | 233 | $452K |
| Dental | CIGNA GROUP INSURANCE -DENTAL | 217 | $126K |
| Vision | VISION SERVICE PLAN | 213 | $27K |
| Life insurance | CIGNA GROUP INSURANCE - BASIC LIFE | 251 | $20K |
| Long-term disability | CIGNA GROUP INSURANCE - LTD | 251 | $62K |
| Other | CIGNA GROUP INSURANCE - ACCIDENTAL DEATH | 251 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 251 | — |
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.