| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | $55K | $2K | $57K | 5.11% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N FIRST ST #202 SAN JOSE, CA 95112 | HARTFORD LIFE AND ACCIDENT | $20K | — | $20K | 10.00% |
| ACRISURE LLC3 | 6307 84TH ST SE CALEDONIA, MI 49316 | HARTFORD LIFE AND ACCIDENT | — | $2K | $2K | 0.95% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $880 | — | $880 | 6.45% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $5K | — | $5K | 41.96% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $397 | — | $397 | 15.33% |
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 | 144 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 144 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 249 | $1.1M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY (G0360) | 249 | $1.1M |
| Vision | VISION SERVICE PLAN | 123 | $14K |
| Life insurance | HARTFORD LIFE AND ACCIDENT | 144 | $202K |
| Long-term disability | HARTFORD LIFE AND ACCIDENT | 144 | $202K |
| Other(3 contracts, 2 carriers) | HARTFORD LIFE AND ACCIDENT | 144 | $216K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 249 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.