| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY, INC. | 7351 E LOWRY BLVD STE 400 DENVER, CO 80230 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 5.13% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY, INC. | 7351 E LOWRY BLVD STE 400 DENVER, CO 80230 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 11.76% |
| DON C SUNDAY3 | 2037 S GRAY DR LAKEWOOD, CO 80227 | AFLAC | $2K | $18 | $2K | 6.94% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY, INC. | 7351 E LOWRY BLVD STE 400 DENVER, CO 80230 | AFLAC | $723 | — | $723 | 2.52% |
| REGINA K SANTANGELO3 | 9034 E EASTER PLACE STE 202 CENTENNIAL, CO 80112 | AFLAC | $478 | $4 | $482 | 1.68% |
| TIMOTHY B ASBY3 | 9247 N MERIDIAN ST STE 205 INDIANAPOLIS, IN 46260 | AFLAC | $140 | — | $140 | 0.49% |
| JILL E MOORE3 | 2985 S OGDEN ST ENGLEWOOD, CO 80113 | AFLAC | $120 | — | $120 | 0.42% |
| JONATHAN SAMUEL KIRKLAND3 | 4245 MILGEN ROAD COLUMBUS, GA 31907 | AFLAC | $114 | — | $114 | 0.40% |
| DAVID HANCOCK INC3 | PO BOX 423 LAVON, TX 75166 | AFLAC | $114 | — | $114 | 0.40% |
| JON M LOUDEN3 | 22739 E PRENTICE PL AURORA, CO 80015 | AFLAC | $114 | — | $114 | 0.40% |
| ZENAT SHARIFF BELKIN3 | 9034 E EASTER PLACE STE 202 CENTENNIAL, CO 80112 | AFLAC | $104 | $3 | $107 | 0.37% |
| JOHN P THOMPSON3 | 6395 S. KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $73 | — | $73 | 0.25% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LANE PHOENIX, AZ 85042 | AFLAC | $63 | — | $63 | 0.22% |
| DAVID V PAYNE3 | 225 EAGLE CT MONROE, MI 48162 | AFLAC | $27 | — | $27 | 0.09% |
| DAVID J KASKA3 | 1862 DENVER WEST CT 224 LAKEWOOD, CO 80401 | AFLAC | $20 | — | $20 | 0.07% |
| JOHN P BUFFINGTON3 | 2944 HWY 85 N NEWCASTLE, WY 82701 | AFLAC | $8 | — | $8 | 0.03% |
| KIEFER GROUP INSURANCE AGCY LLC3 | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80112 | AFLAC | $3 | $4 | $7 | 0.02% |
| JEANNE R BUFFINGTON3 | 24944 N US HIGHWAY 85 NEWCASTLE, WY 82701 | AFLAC | $5 | — | $5 | 0.02% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY, INC. | 7351 E LOWRY BLVD STE 400 DENVER, CO 80230 | VISION SERVICE PLAN | $1K | — | $1K | 5.09% |
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 | 98 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 35 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 133 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 94 | $24K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 98 | $62K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 98 | $30K |
| Other(2 contracts, 2 carriers) | MEDAMERICA INSURANCE COMPANY | 126 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 126 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.