| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 500 N BRAND BLVD STE 100 GLENDALE, CA 91203 | KAISER FOUNDATION HEALTH PLAN INC. | $40K | $0 | $40K | 2.79% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SERVICES, LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | KAISER FOUNDATION HEALTH PLAN INC. | $24K | $0 | $24K | 1.65% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 ARLINGTON HEIGHTS, IL 60006 | CIGNA HEALTHCARE OF CALIFORNIA | $27K | $0 | $27K | 2.51% |
| DANONE SIMPSON INSURANCE SERVICES3 | DBA MONTAGE INSURANCE SERVICES 5550 TOPANGA CANYON BLVD., STE. 310 WOODLAND HILLS, CA 91367 | CIGNA HEALTHCARE OF CALIFORNIA | $22K | $0 | $22K | 2.08% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 ARLINGTON HTS, IL 60006 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $42K | $0 | $42K | 4.48% |
| DANONE SIMPSON INSURANCE SERVICES3 | DBA MONTAGE INSURANCE SERVICES 5500 TOPANGA CANYON BLVD., STE. 310 WOODLAND HILLS, CA 91367 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $34K | $0 | $34K | 3.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | NEW YORK LIFE GROUP INSURANCE COMPANY | $4K | $0 | $4K | 8.79% |
| DANONE SIMPSON INSURANCE SERVICES3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | NEW YORK LIFE GROUP INSURANCE COMPANY | $3K | $1K | $4K | 8.62% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | NEW YORK LIFE GROUP INSURANCE COMPANY | $0 | $118 | $118 | 0.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.18% |
| DANONE SIMPSON INSURANCE SERVICES3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | VISION SERVICE PLAN | $2K | $0 | $2K | 4.16% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IA 60006 | NEW YORK LIFE GROUP INSURANCE COMPANY | $2K | $0 | $2K | 9.63% |
| DANONE SIMPSON INSURANCE SERVICES3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | NEW YORK LIFE GROUP INSURANCE COMPANY | $1K | $518 | $2K | 7.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | NEW YORK LIFE GROUP INSURANCE COMPANY | $0 | $59 | $59 | 0.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $0 | $1K | 8.78% |
| DANONE SIMPSON INSURANCE SERVICES3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $410 | $1K | 8.64% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $0 | $41 | $41 | 0.24% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $924 | $0 | $924 | 6.98% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SERV LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $884 | $0 | $884 | 6.67% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $915 | $0 | $915 | 7.05% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SERV LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $855 | $0 | $855 | 6.59% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD ROLLING MEADOWS, IL 60008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $655 | $0 | $655 | 6.90% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SERV LLC | 24005 VENTURA BLVD CALABASAS, CA 91302 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $639 | $0 | $639 | 6.73% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 21ST FL ARLINGTON HEIGHTS, IL 60006 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $222 | $0 | $222 | 8.77% |
| MONTAGE INSURANCE SOLUTIONS3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $157 | $18 | $175 | 6.92% |
| DANONE SIMPSON INSURANCE SERVICES3 | 24005 VENTURA BLVD CALABASAS, CA 91302 | NEW YORK LIFE GROUP INSURANCE COMPANY | $109 | $46 | $155 | 8.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 21ST FLOOR ARLINGTON HEIGHTS, IL 60006 | NEW YORK LIFE GROUP INSURANCE COMPANY | $155 | $0 | $155 | 8.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF RD 5TH FLOOR ROLLING MEADOWS, IL 60008 | NEW YORK LIFE GROUP INSURANCE COMPANY | $0 | $4 | $4 | 0.23% |
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 | 280 | 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) | 280 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 202 | $3.5M |
| Vision | VISION SERVICE PLAN | 291 | $41K |
| Life insurance(3 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY | 290 | $41K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY | 290 | $49K |
| Prescription drug | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 83 | $927K |
| Other(5 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 290 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.