| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NEVADA | 2340 CORPORATE CIRCLE HENDERSON, NV 89074 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | $106K | — | $106K | 4.08% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | PO BOX 3070 RICHMOND, VA 23228 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | — | $5K | $5K | 0.20% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS. SVCS. | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | -$23 | — | -$23 | -0.00% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: CRAGIN & PIKE INC | 2603 W CHARLESTON BLVD LAS VEGAS, NV 89102 | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | -$6K | — | -$6K | -0.22% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NEVADA | 975 KELLY JOHNSON DRIVE STE 100 LAS VEGAS, NV 89119 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | $4K | $21K | 11.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NEVADA | 2340 CORPORATE CIRCLE HENDERSON, NV 89074 | ANTHEM LIFE INSURANCE COMPANY | $12K | — | $12K | 7.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGY OF VA INC | PO BOX 3070 RICHMOND, VA 23228 | ANTHEM LIFE INSURANCE COMPANY | — | $571 | $571 | 0.35% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INSURANCE | 1920 MAIN ST #600 IRVINE, CA 92614 | ANTHEM LIFE INSURANCE COMPANY | -$3 | — | -$3 | -0.00% |
| CRAIG AND PIKE, INC.3 Filed as: CRAIG & PIKE INC | 2603 W CHARLESTON BLVD LAS VEGAS, NV 89102 | ANTHEM LIFE INSURANCE COMPANY | -$640 | — | -$640 | -0.39% |
| TABELLO INS SERVICES INC3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $1K | $289 | $1K | 7.25% |
| TOAN HUU PHAM3 | 546 S HARBOR BLVD SANTA ANA, CA 92704 | AFLAC | $389 | $195 | $584 | 3.13% |
| JONATHAN ALI HAJIMOMEN3 | 1561 E ORANGETHORPE AVE STE 200 FULLERTON, CA 92831 | AFLAC | $354 | $116 | $470 | 2.52% |
| ACRISURE LLC3 Filed as: SULLIVAN CURTIS MONROE INS SVCS LLC | 1920 MAIN STREET, SUITE 600 IRVINE, CA 92614 | AFLAC | $422 | — | $422 | 2.26% |
| BARBARA LYNN BRINSON3 | 2841 S SANDPIPER AVE ONTARIO, CA 91761 | AFLAC | $41 | $36 | $77 | 0.41% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AFLAC | $49 | — | $49 | 0.26% |
| BRENDA F ROY3 | 341 STILLWATER LOOP KALISPELL, MT 59901 | AFLAC | $11 | — | $11 | 0.06% |
| COLISTA R SHETLER3 | 2418 PEBBLE SPRINGS CT HENDERSON, NV 89074 | AFLAC | $9 | — | $9 | 0.05% |
| DAWN A CHRISTENSEN3 | 24516 APPLE ST NEWHALL, CA 91321 | AFLAC | $7 | — | $7 | 0.04% |
| LYNN MARIE BARRY3 Filed as: LYNN G BARNSON | 10153 S WASATCH BLVD SANDY, UT 84902 | AFLAC | $6 | — | $6 | 0.03% |
| COLISTA R SHETLER3 | 9003 BELCONTE LN HENDERSON, NV 89074 | AFLAC | $1 | — | $1 | 0.01% |
| TAMMY A MORGART3 Filed as: TAMMY A SWAIN | 10736 KNICKERBOCKER AVE LAS VEGAS, NV 89166 | AFLAC | $1 | — | $1 | 0.01% |
| WILLIAM B KRZCIOK3 | 2760 FORT MYER AVE HENDERSON, NV 89052 | AFLAC | $1 | — | $1 | 0.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NEVADA | 975 KELLY JOHNSON DR STE 100 LAS VEGAS, NV 89119 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 28.01% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: CRAGIN & PIKE INC. | 2603 W CHARLESTON BLVD LAS VEGAS, NV 89102 | UNUM LIFE INSURANCE COMPANY OF AMERICA | -$729 | — | -$729 | -8.51% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF NEVADA | 975 KELLY JOHNSON DRIVE STE 100 LAS VEGAS, NV 89119 | ARAG INSURANCE COMPANY | $307 | — | $307 | 7.79% |
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 | 208 | 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) | 208 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 208 | $2.6M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 185 | $184K |
| Vision(2 contracts, 2 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 208 | $2.8M |
| Life insurance | ANTHEM LIFE INSURANCE COMPANY | 208 | $163K |
| Short-term disability | ANTHEM LIFE INSURANCE COMPANY | 208 | $163K |
| Long-term disability | ANTHEM LIFE INSURANCE COMPANY | 208 | $163K |
| Prescription drug | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 208 | $2.6M |
| Other(4 contracts, 4 carriers) | ROCKY MOUNTAIN HOSPITAL AND MEDICAL SERVICE, INC. | 208 | $2.6M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 208 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.