Form 5500 · Employee benefit plan · PUEBLO, CO
SOUTHERN COLORADO CLINIC P.C.
The filing calls this plan SOUTHERN COLORADO CLINIC P.C. EMPLOYEE BENEFITS PLAN.
SOUTHERN COLORADO CLINIC P.C. of PUEBLO, CO spreads its employee benefits across 3 insurance carriers, according to its Form 5500 Schedule A. Its broker of record is BENEFITS BROKER, INC. Coverage is written through ALL SAVERS INSURANCE COMPANY and 2 other carriers. The plan's most recent policy period ended in December.
Sourced from U.S. DOL EFAST2 Form 5500 · EIN 84-1074070 · plan 501 · plan year 2025, filed Jul 15, 2026
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How this plan is funded
Self-funded as reported
The filing reports a stop-loss contract and no medical premium, which is what a plan that pays its own claims reports.
A stop-loss policy appears on a Form 5500 only when the plan itself is the beneficiary, or the premiums are paid from plan money. Many employers buy stop-loss and never report it here. So a plan with no stop-loss on its filing may still have it.
Benefits declared on this filing
Also declared: other welfare.
Declared benefits are the plan’s own line 8b codes on Form 5500. “Not on Schedule A” means no insured contract for that line appears on this filing. That usually means the benefit is self-funded, or it sits under a different plan number.
Where a line has more than one insured contract, the carrier and the covered figure are the largest contract's by premium. The contracts are not added up: a pharmacy carve-out and the medical carrier beside it cover the same people.
Persons covered is the count the carrier filed for that policy at the end of its policy year, and it can include dependents. Participants is the plan's own count at the start of its plan year. The two count different people, so a covered figure can be larger.
Plan brief
Schedule A lists 5 insured contracts covering dental, vision, life, disability and stop-loss; the largest, with ALL SAVERS INSURANCE COMPANY, covers 84 people.
The filing declares dental, vision, life, disability and health. Health appears with no insured contract on Schedule A. That coverage may be self-funded, or placed with a carrier that is not on this filing.
The only insured piece of the health benefit is stop-loss coverage, and the filing reports the plan paying its own claims. The stop-loss contract reports $398,871 in premium and $26,104 in commission. The rest of the premium and commission above is on the plan's other insured lines, and none of it is medical premium.
Reported premium across the insured contracts is $572,304, with $34,694 in disclosed broker commissions — about 6.1% of premium.
The most recent policy period ended in December, and the plan year ends December 31. Group contracts typically renew on that annual cycle.
Schedule A insurance contracts
| Carrier | Benefits | Covered | Renews | Premium | Commission |
|---|---|---|---|---|---|
| ALL SAVERS INSURANCE COMPANY | Stop-loss | 84 | Jan 1, 2026 | $398,871 | $26,104 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life, Disability | 115 | Jan 1, 2026 | $95,439 | $5,694 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Life | 50 | Jan 1, 2026 | $13,571 | $2,158 |
| UNUM LIFE INSURANCE COMPANY OF AMERICA | Disability | 22 | Jan 1, 2026 | $4,578 | $738 |
| UNITEDHEALTHCARE INSURANCE COMPANY | Dental, Vision | 84 | Jan 1, 2026 | $59,845 | $0 |
Covered = persons covered at policy year end, as filed on Schedule A for that policy — often certificates or one class, not the whole plan. Premium = the filing’s own premium/charges figure; “—” means not credibly reported.
Administrator and service providers
The plan administrator is from line 3a of the main form. We publish company names only.
How this plan compares
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