| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI-MILLER BENEFITS, LLC | 8205 WEST 20TH STREET GREELEY, CO 80634 | SUN LIFE ASSURANCE COMPANY OF CANADA | $21K | $0 | $21K | 13.97% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI-MILLER BENEFITS, LLC | 8205 WEST 20TH STREET GREELEY, CO 80634 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | $0 | $4K | 17.84% |
| T2B SOLUTIONS INC.3 Filed as: T2B SOLUTIONS, INC. | PO BOX 43 INDIANOLA, IA 50125 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $0 | $1K | $1K | 5.14% |
| SHIRAZI-MILLER BENEFITS LLC3 Filed as: SHIRAZI-MILLER BENEFITS, LLC | 8205 WEST 20TH STREET GREELEY, CO 80634 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.74% |
| PFS INSURANCE GROUP LLC3 Filed as: PFS INSURANCE GROUP, LLC | 4848 THOMPSON PARKWAY, SUITE 200 JOHNSTOWN, CO 80534 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $33 | $0 | $33 | 0.16% |
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 | 138 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Vision | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $149K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $149K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $149K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $149K |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 303 | $192K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 303 | — |
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.