| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY INC | 7351 LOWRY BLVD STE 400 DENVER, CO 80230 | PRINCIPAL LIFE INSURANCE COMPANY | $9K | — | $9K | 7.92% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC INSURANCE AGENCY INC | 7351 LOWRY BLVD STE400 DENVER, CO 80230 | SUN LIFE ASSURANCE COMPANY OF CANADA | $5K | — | $5K | 7.49% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC AGENCY | 7351 LOWRY BLVD STE 400 DENVER, CO 80230 | VISION SERVICE PLAN | $1K | — | $1K | 5.04% |
| DON C SUNDAY3 | 2037 S GRAY DR LAKEWOOD, CO 80227 | AFLAC | $1K | $178 | $1K | 6.34% |
| COPIC INSURANCE AGENCY3 Filed as: COPIC AGENCY | 7351 LOWRY BLVD STE 400 DENVER, CO 80230 | AFLAC | $398 | — | $398 | 2.02% |
| REGINA K SANTANGELO3 | 6892 S WEBSTER WAY LITTLETON, CO 80128 | AFLAC | $316 | $36 | $352 | 1.78% |
| JENNIFER L FOSS3 | 9034 E EASTER PL STE 202 CENTENNIAL, CO 80112 | AFLAC | $134 | $36 | $170 | 0.86% |
| TIMOTHY B ASBY3 | 11500 GOLDEN WILLOW CT ZIONSVILLE, IN 46077 | AFLAC | $85 | — | $85 | 0.43% |
| JOHNATHAN SAMUEL KIRKLAND3 | 4245 MILGEN RD COLUMBUS, GA 31907 | AFLAC | $73 | — | $73 | 0.37% |
| JON M LOUDEN3 | 22739 E PRENTICE PL AURORA, CO 80015 | AFLAC | $51 | — | $51 | 0.26% |
| DAVID HANCOCK INC3 | PO BOX 423 LAVON, TX 75166 | AFLAC | $51 | — | $51 | 0.26% |
| JACK GATHINGS3 | 7235 S GOLFSIDE LN PHOENIX, AZ 85042 | AFLAC | $50 | — | $50 | 0.25% |
| JILL E MOORE3 | 2985 S OGDEN ST ENGLEWOOD, CO 80113 | AFLAC | $49 | — | $49 | 0.25% |
| JOHN P THOMPSON3 | 6395 S KEWAUNEE WAY STE 425 AURORA, CO 80016 | AFLAC | $29 | — | $29 | 0.15% |
| DAVID V PAYNE3 | 225 EAGLE CT MONROE, MI 48162 | AFLAC | $21 | — | $21 | 0.11% |
| JOSE DE LOS SANTOS III3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $18 | — | $18 | 0.09% |
| DAVID J KASKA3 | 1862 DENVER WEST CT #224 LAKEWOOD, CO 80401 | AFLAC | $17 | — | $17 | 0.09% |
| TINA WAY3 | 15550 E COPPER CREEK LN PARKER, CO 80134 | AFLAC | $11 | — | $11 | 0.06% |
| ZENAT SHARIFF BELKIN3 | 14204 W EVANS CIR LAKEWOOD, CO 80228 | AFLAC | $11 | — | $11 | 0.06% |
| ZENAT SHARIFF BELKIN3 | 9034 E EASTER PL STE 202 CENTENNIAL, CO 80112 | AFLAC | $8 | — | $8 | 0.04% |
| ALLISON FARRIS WENDELBERGER3 | 207 SANTA FE DR WALNUT CREEK, CA 94598 | AFLAC | $3 | — | $3 | 0.02% |
| JOHN W AMOS3 Filed as: JOHN P THOMPSON JR | 343 SABAL SPRINGS CT DEBARY, FL 32713 | AFLAC | $2 | — | $2 | 0.01% |
| TANYA L MARTINSON3 | 6395 S KEWAUNEE WAY AURORA, CO 80016 | AFLAC | $2 | — | $2 | 0.01% |
| KIEFER GROUP INSURANCE AGCY LLC3 | 155 INVERNESS DR W STE 300 ENGLEWOOD, CO 80112 | AFLAC | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| OPTUM RX INC EIN 33-0441200 PHARMACY BENEFIT MGMT | Direct payment from the plan; Other fees; Float revenue; Claims processing Service code 12 | — | $159K |
| UMR INC EIN 39-1995276 CLAIMS PROCESSING | Claims processing Service code 12 | — | $112K |
| COPIC INSURANCE COMPANY EIN 84-0953991 BROKER | Other commissions Service code 55 | 7351 E LOWRY BLVD STE400 DENVER, CO 80230 | $53K |
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 | 102 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | VISION SERVICE PLAN | 99 | $25K |
| Life insurance(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 279 | $180K |
| Short-term disability | AFLAC | 17 | $20K |
| Long-term disability(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 279 | $180K |
| Other(3 contracts, 3 carriers) | COPIC INSURANCE COMPANY | 125 | $157K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 279 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.