| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY ST STE 101 LONGMONT, CO 80501 | AMERITAS LIFE INSURANCE CORP | $4K | — | $4K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES N | 32110 AGOURA RD. WESTLAKE VILLAGE, CA 91361 | AMERITAS LIFE INSURANCE CORP | $2K | — | $2K | 5.00% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO, LLC | 2040 TERRY ST STE 101 LONGMONT, CO 80501 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.24% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICE | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 8.62% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 43110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $561 | — | $561 | 7.35% |
| VOLUNTARY SOLUTIONS INC3 | 9720 E 151ST PLACE BRIGHTON, CO 80602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $187 | — | $187 | 2.45% |
| CONEXUS INSURANCE PARTNERS INC3 | 11080 CIRCLE POINT RD WESTMINISTER, CO 80020 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $181 | — | $181 | 2.37% |
| RPM BENEFIT ADVISORS LLC3 | 489 ROAD 209 BIG SPRINGS, NE 69122 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $77 | — | $77 | 1.01% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO LLC | 2040 TERRY STREET STE 101 LONGMONT, CO 80501 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $42 | — | $42 | 0.55% |
| SELECTIVE OPTIONS INC3 Filed as: SELECTIVE OPTIONS INC. | 9720 E 151ST PLACE BRIGHTON, CO 80602 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $15 | — | $15 | 0.20% |
| GBS BENEFITS INS AGENCY3 Filed as: GBS COLORADO, LLC | 2040 TERRY ST STE 101 LONGMONT, CO 80501 | UNUM INSURANCE COMPANY | $497 | — | $497 | 9.26% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICE | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNUM INSURANCE COMPANY | — | $249 | $249 | 4.64% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | 12404 PARK CENTRAL DR. STE 400S DALLAS, TX 75251 | ROCKY MOUNTAIN HOSPITAL & MEDICAL SERVICE INC. | — | $451 | $451 | — |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| ROCKY MOUNTAIN HOSPITAL & MEDICAL EIN 84-0747736 CLAIMS PROCESSING | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing; Float revenue Service code 12 | — | $20K |
| CENTERSTONE INSURANCE AND FINANCIAL EIN 95-4018229 INSURANCE AGENT | Insurance agents and brokers; Other commissions; Non-monetary compensation Service code 22 | — | $0 |
| GBS COLORADO LLC EIN 81-3387763 BROKER | Insurance agents and brokers; Other commissions; Insurance brokerage commissions and fees Service code 22 | — | $0 |
| INGENIORX, INC. EIN 82-3062245 PRESCRIPTION DRUG | Float revenue; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $0 |
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 | 152 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | AMERITAS LIFE INSURANCE CORP | 127 | $43K |
| Vision | AMERITAS LIFE INSURANCE CORP | 127 | $43K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $43K |
| Short-term disability | UNUM INSURANCE COMPANY | 22 | $5K |
| Stop-loss / reinsurancereinsurance(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL & MEDICAL CARE, INC. | 85 | $253K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 130 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 130 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.