| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $55K | — | $55K | 5.28% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD & BROWN INSURANCE ADMINISTRATO | 721 S PARKER STREET ORANGE, CA 92868 | BLUE CROSS OF CALIFORNIA | — | $23K | $23K | 2.21% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SERVICES LL | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $5K | — | $5K | 0.48% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $29K | — | $29K | 3.59% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | PRINCIPAL LIFE INSURANCE COMPANY | $10K | — | $10K | 7.69% |
| GA SOLUTIONS LLC3 | 311 CLOCK TOWER CMNS BREWSTER, NY 10509 | PRINCIPAL LIFE INSURANCE COMPANY | — | $4K | $4K | 3.18% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: WORD AND BROWN BENEFIT ADMIN | 721 S PARKER ST, STE 300 ORANGE, CA 92868 | PRINCIPAL LIFE INSURANCE COMPANY | — | $2K | $2K | 1.31% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 1.29% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $4K | 14.68% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COASTINSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $262 | — | $262 | 0.87% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $897 | $2K | 14.65% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $140 | — | $140 | 0.86% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 1150 MORAGA WAY MORAGA, CA 94556 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $940 | $571 | $2K | 14.68% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $89 | — | $89 | 0.86% |
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 | 127 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 127 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 139 | $1.9M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 228 | $134K |
| Vision | PRINCIPAL LIFE INSURANCE COMPANY | 228 | $134K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $16K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $10K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $30K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 133 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.