| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: TBG DANCO INSURANCE SERVICES CORPOR | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | HEALTH NET | $50K | $0 | $50K | 5.80% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | RELIANCE STANDARD INSURANCE COMPANY | $9K | $0 | $9K | 15.00% |
| THOMAS DANCO3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | VISION SERVICE PLAN | $868 | $0 | $868 | 6.03% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: TBG DANCO, INC. | 11150 SANTA MONICA BLVD SUITE 800 LOS ANGELES, CA 90025 | CALIFORNIA DENTAL NETWORK, INC. | $966 | $0 | $966 | 10.00% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $78 | $1K | 16.12% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 Filed as: THE EMPLOYERS BENEFIT GROUP LLC | 11150 SANTA MONICA BLVD STE 800 LOS ANGELES, CA 90025 | NIPPON LIFE INSURANCE COMPANY OF AMERICA | $813 | $0 | $813 | 15.06% |
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 | 140 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 140 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HEALTH NET | 89 | $871K |
| Dental(2 contracts, 2 carriers) | RELIANCE STANDARD INSURANCE COMPANY | 121 | $70K |
| Vision | VISION SERVICE PLAN | 106 | $14K |
| Life insurance | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 140 | $5K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 10 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 10 | $7K |
| Prescription drug | HEALTH NET | 89 | $871K |
| Other | NIPPON LIFE INSURANCE COMPANY OF AMERICA | 140 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 140 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.