| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 400 GALLERIA PKWY #300 ATLANTA, GA 30339 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $50K | $3K | $54K | 4.79% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 THOUSAND OAKS BLVD #325 THOUSAND OAKS, CA 91362 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $2K | — | $2K | 0.14% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD #325 WESTLAKE VILLAGE, CA 91359 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $9K | — | $9K | 10.00% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | PO BOX 6549 THOUSAND OAKS, CA 91359 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 15.06% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD #325 WESTLAKE VILLAGE, CA 91362 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | PO BOX 6549 THOUSAND OAKS, CA 91359 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 14.66% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD #325 WESTLAKE VILLAGE, CA 91362 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| NIELSEN INSURANCE GROUP INC3 | PO BOX 6549 THOUSAND OAKS, CA 91359 | UNUM LIFE INSURANCE COMPANY | $947 | — | $947 | 15.00% |
| NIELSEN INSURANCE GROUP INC3 | 4165 E THOUSAND OAKS BLVD. #325 THOUSAND OAKS, CA 91362 | TRANSAMERICA LIFE INSURANCE COMPANY | $733 | — | $733 | 12.33% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY #1950 ATLANTA, GA 30339 | TRANSAMERICA LIFE INSURANCE COMPANY | $504 | — | $504 | 8.47% |
| DIGITAL INSURANCE LLC3 | 200 GALLERA PKWY STE 1950 ATLANTA, GA 30339 | TRANSAMERICA LIFE INSURANCE COMPANY | $570 | — | $570 | 9.68% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD #325 THOUSAND OAKS, CA 91362 | TRANSAMERICA LIFE INSURANCE COMPANY | $452 | — | $452 | 7.67% |
| DIGITAL INSURANCE LLC3 | 200 GALLERIA PKWY STE 1950 ATLANTA, GA 30339 | TRANSAMERICA LIFE INSURANCE COMPANY | $443 | — | $443 | 10.81% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD. #325 THOUSAND OAKS, CA 91362 | TRANSAMERICA LIFE INSURANCE COMPANY | $307 | — | $307 | 7.49% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | 4165 E THOUSAND OAKS BLVD. #325 WESTLAKE VILLAGE, CA 91362 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $125 | — | $125 | 10.02% |
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 | 113 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 113 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 120 | $1.1M |
| Dental | RELIANCE STANDARD LIFE INSURANCE COMPANY | 264 | $92K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 120 | $1.1M |
| Life insurance(2 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 120 | $1.1M |
| Long-term disability | RELIANCE STANDARD LIFE INSURANCE COMPANY | 115 | $16K |
| Other(8 contracts, 4 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 122 | $89K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 264 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.