| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. WOODLAND HILLS, CA 91367 | AETNA LIFE INSURANCE CO. | $49K | $3K | $51K | 3.79% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | AETNA LIFE INSURANCE CO. | $19K | — | $19K | 1.40% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD STE 310 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $4K | — | $4K | 2.76% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 2055 GATEWAY PL STE 430 SAN JOSE, CA 95110 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 1.01% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. WOODLAND HILLS, CA 91367 | AETNA HEALTH, INC. | $5K | — | $5K | 3.40% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | PO BOX 101162 PASADENA, CA 91189 | AETNA HEALTH, INC. | $2K | — | $2K | 1.22% |
| MONTAGE INSURANCE SOLUTIONS3 | 5550 TOPANGA CANYON BLVD STE 310 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | — | $3K | 10.16% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 4.83% |
| MONTAGE INSURANCE SOLUTIONS3 | 5550 TOPANGA CANYON BLVD STE 310 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.23% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $963 | — | $963 | 4.77% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SCVS LLC | 5550 TOP CYN BLVD STE 310 WOODLAND HLS, CA 91367 | AMERITAS LIFE INSURANCE CORP. | $1K | — | $1K | 6.57% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SVCS WEST | 525 MARKET ST STE 3400 SAN FRANCISCO, CA 94105 | AMERITAS LIFE INSURANCE CORP. | $655 | — | $655 | 3.43% |
| MONTAGE INSURANCE SOLUTIONS3 | 5550 TOPANGA CANYON BLVD STE 310 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $2K | — | $2K | 10.39% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $755 | — | $755 | 4.61% |
| MONTAGE INSURANCE SOLUTIONS3 | 5550 TOPANGA CANYON BLVD STE 310 WOODLAND HILLS, CA 91367 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $359 | — | $359 | 10.04% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INSURANCE | PO BOX 101162 PASADENA, CA 91189 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $178 | — | $178 | 4.98% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SVCS. | 580 CALIFORNIA ST, #1300 SAN FRANCISCO, CA 94104 | FEDERAL INSURANCE COMPANY | $518 | $93 | $611 | 17.71% |
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 | 115 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 6 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 123 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | AETNA LIFE INSURANCE CO. | 226 | $1.7M |
| Dental | AETNA LIFE INSURANCE CO. | 226 | $1.4M |
| Vision | AMERITAS LIFE INSURANCE CORP. | 239 | $19K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $16K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $20K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 115 | $33K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE CO. | 226 | $1.5M |
| Other(3 contracts, 3 carriers) | MANAGED HEALTH NETWORK | 219 | $13K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 239 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.