| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $17K | $0 | $17K | 40.71% |
| PACIFIC ADVISORS LLC3 Filed as: PACIFIC ADVISORS | 333 INDIAN HILL BLVD CLAREMONT, CA 91711 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $0 | $1K | 3.05% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. | DBA MONTAGE INSURANCE SOLUTIONS 5550 TOPANGA CANYON BLVD., STE 310 WOODLAND HILLS, CA 91367 | EYEMED VISION CARE | $3K | $0 | $3K | 10.02% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 7.00% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SERVICES LLC | 5550 TOPANGA CANYON BLVD SUITE 310 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $0 | $5K | 25.00% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS SERVICES LLC | 5550 TOPANGA CANYON BLVD SUITE 310 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $0 | $2K | 15.00% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $590 | $0 | $590 | 15.01% |
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 | 236 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 237 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 468 | $2.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 202 | $43K |
| Vision | EYEMED VISION CARE | 350 | $30K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $25K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $27K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 236 | $25K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 468 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.