| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INC | PO BOX 678 DECATUR, IL 62525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $10K | $235 | $11K | 5.40% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 1.72% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INC | PO BOX 678 DECATUR, IL 62525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $10K | 12.02% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.96% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INC | PO BOX 678 DECATUR, IL 62525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 11.68% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $484 | — | $484 | 1.28% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INC | PO BOX 678 DECATUR, IL 62525 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 13.70% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INCORPORATED | 111 E DECATUR ST DECATUR, IL 62521 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $521 | — | $521 | 1.68% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INSURANCE SERVICES | 2828 N MONROE ST DECATUR, IL 62526 | VISION SERVICE PLAN | $849 | — | $849 | 3.66% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANSIG INSURANCE SERVICES | PO BOX 678 DECATUR, IL 62525 | VISION SERVICE PLAN | $351 | — | $351 | 1.51% |
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 | 409 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 409 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | IRONSHORE INDEMNITY INC. | 359 | $433K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 257 | $199K |
| Vision | VISION SERVICE PLAN | 263 | $23K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 409 | $122K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 409 | $31K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 409 | $122K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 409 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.