| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INS. SVCS. LLC | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 91367 | UNITED HEALTHCARE INSURANCE COMPANY | $115K | $0 | $115K | 2.55% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP INC. | PO BOX 6549 THOUSAND OAKS, CA 913596549 | UNITED HEALTHCARE INSURANCE COMPANY | $82K | $0 | $82K | 1.83% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SVCS., LLC | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 913677444 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | $0 | $9K | 2.52% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC. | 4165 E THOUSAND OAKS BLVD. SUITE 325 WESTLAKE VILLAGE, CA 913623850 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | $0 | $6K | 1.66% |
| CARLA MAGARITY3 | 2701 SPRING GATE PLACE MIDLOTHIAN, VA 231124324 | KAISER FOUNDATION HEALTH PLAN INC. | $627 | $0 | $627 | 0.17% |
| MONTAGE INSURANCE SOLUTIONS3 Filed as: MONTAGE INSURANCE | 5550 TOPANGA CANYON BLVD., STE. 310 WOODLAND HILLS, CA 91367 | UNITED HEALTHCARE INSURANCE COMPANY | $6K | $0 | $6K | 3.12% |
| DANONE SIMPSON INSURANCE SERVICES3 | 5550 TOPANGA CANYON BLVD. SUITE 310 WOODLAND HILLS, CA 913677444 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | $0 | $3K | 4.41% |
| CARLA SUE MAGARITY3 | 2701 SPRING GATE PLACE MIDLOTHIAN, VA 23112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $913 | $0 | $913 | 2.67% |
| NIELSEN INSURANCE GROUP INC3 Filed as: NIELSEN INSURANCE GROUP, INC. | PO BOX 6549 THOUSAND OAKS, CA 91359 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $792 | $0 | $792 | 2.31% |
| DANONE SIMPSON INSURANCE SERVICES3 Filed as: DANONE SIMPSON INSURANCE SVCS., LLC | 5550 TOPANGA CANYON BLVD. SUITE 300 WOODLAND HILLS, CA 91367 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $695 | $0 | $695 | 2.03% |
| CARLA SUE MAGARITY3 | 2701 SPRING GATE PLACE MIDLOTHIAN, VA 23112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $179 | $0 | $179 | 1.10% |
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 | 265 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 271 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 693 | $4.9M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 693 | $4.5M |
| Vision | UNITED HEALTHCARE INSURANCE COMPANY | 693 | $4.5M |
| Life insurance(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 578 | $195K |
| Long-term disability | UNITED HEALTHCARE INSURANCE COMPANY | 578 | $179K |
| Other(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 578 | $213K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 693 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.