| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| THOMAS DANCO3 Filed as: THOMAS P DANCO | 11150 SANTA MONICA BLVD SUITE 800 LOS ANGELES, CA 90025 | CALIFORNIA PHYSICIANS' SERVICE | $48K | $0 | $48K | 5.00% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 Filed as: THE EMPLOYERS BENEFIT GROUP | 11150 SANTA MONICA BLVD SUITE 800 LOS ANGELES, CA 90025 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | $13K | $0 | $13K | 14.13% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 Filed as: THE EMPLOYERS BENEFIT GROUP LLC | 11150 SANTA MONICA BLVD SUITE 800 LOS ANGELES, CA 90025 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $0 | $3K | 16.30% |
| THE EMPLOYERS BENEFIT GROUP, LLC3 Filed as: THE EMPLOYERS BENEFIT GROUP | 11150 SANTA MONICA BLVD SUITE 800 LOS ANGELES, CA 90025 | CIGNA DENTAL HEALTH OF CALIFORNIA | $682 | $0 | $682 | 14.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| TBG DANCO, INC. EIN 95-4762722 BROKER | Insurance brokerage commissions and fees Service code 53 | 11150 SANTA MONICA BLVD SUITE 800 LOS ANGELES, CA 90025 | $8K |
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 | 153 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Beneficiaries receiving benefits | 0 | Spouses or dependents with eligibility independent of the participant. |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | CALIFORNIA PHYSICIANS' SERVICE | 308 | $966K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES (CIGNA) | 126 | $97K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $15K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $15K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 308 | $966K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 153 | $15K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 308 | — |
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.