| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THE EMPLOYERS BENEFIT GROUP, LLC3 Filed as: THE EMPLOYERS BENEFIT GROUP | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | HARTFORD LIFE AND ACCIDENT | $4K | — | $4K | 2.22% |
| BENEFIT ADVISOR SERVICES GROUP LLC3 Filed as: BENEFIT ADVISOR SERVICES GRP | 1125 SANCTUARY PARKWAY STE 300 ALPHARETTA, GA 30009 | HARTFORD LIFE AND ACCIDENT | $3K | — | $3K | 1.62% |
| ALLIANT INSURANCE SERVICES, INC.3 Filed as: ALLIANT INSURANCE SVCS INC. | 701 B STREET, 6TH FLOOR SAN DIEGO, CA 92101 | HARTFORD LIFE AND ACCIDENT | — | $326 | $326 | 0.20% |
| KEELER & ASSOCIATES3 | 211 S. 23RD STREET PLATTSMOUTH, NE 68048 | RELIASTAR LIFE INSURANCE COMPANY | $13K | — | $13K | 15.26% |
| THOMAS DANCO3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | RELIASTAR LIFE INSURANCE COMPANY | $9K | — | $9K | 9.71% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: CLARENCE GALLAGHER | 211 S. 23RD ST. PLATTSMOUTH, NE 68048 | RELIASTAR LIFE INSURANCE COMPANY | $1K | — | $1K | 1.39% |
| SHAWN J KEELER3 Filed as: SHAWN KEELER | 211 S. 23RD ST. PLATTSMOUTH, NE 68048 | RELIASTAR LIFE INSURANCE COMPANY | $1K | — | $1K | 1.39% |
| THOMAS DANCO3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 10.00% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | VISION SERVICE PLAN (VSP) | $1K | — | $1K | 4.62% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: TBG DANCO INSURANCE SERVICES | 11150 SANTA MONICA BLVD #800 LOS ANGELES, CA 90025 | DELTA DENTAL OF ILLINOIS | $9K | — | $9K | 38.94% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | NATIONAL UNION FIRE INSURANCE CO OF PITTSBURGH | $375 | — | $375 | 17.48% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| COMMUNITY INSURANCE COMPANY EIN 31-1440175 CLAIMS PROCESSING | Contract Administrator; Other services; Float revenue; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | — | $335K |
| THE EMPLOYERS BENEFIT GROUP, LLC INSURANCE BROKER | Insurance agents and brokers; Insurance brokerage commissions and fees; Other commissions Service code 22 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | $159K |
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 | 538 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 541 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF ILLINOIS | 304 | $24K |
| Vision | VISION SERVICE PLAN (VSP) | 268 | $32K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 534 | $163K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 394 | $88K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 139 | $41K |
| Stop-loss / reinsurancereinsurance | ANTHEM COMMUNITY INSURANCE COMPANY | 803 | $443K |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 673 | $90K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 803 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.