| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST DECATUR, IL 62521 | BLUECROSS BLUESHIELD OF ILLINOIS | $31K | — | $31K | 3.92% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INC | 111 E. DECATUR ST. DECATUR, IL 62525 | DELTA DENTAL | $6K | — | $6K | 7.50% |
| BAUGHMAN GROUP3 Filed as: BAUGHMAN GROUP INC | 1375 EAST US 50 NOBLE, IL 62868 | DELTA DENTAL | — | $2K | $2K | 2.50% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST. DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $9K | 20.77% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $9K | 21.11% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPOATED | 111 E DECATUR ST. DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $858 | $3K | 20.76% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST. DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $820 | $3K | 20.73% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INSURANCE SERVICES | PO BOX 678 DECATUR, IL 62525 | VISION SERVICE PLAN | $1K | — | $1K | 10.00% |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 213 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD OF ILLINOIS | 210 | $802K |
| Dental | DELTA DENTAL | 103 | $85K |
| Vision | VISION SERVICE PLAN | 75 | $12K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $59K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $45K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $15K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 137 | $59K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.