| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $137K | $4 | $137K | 5.81% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | PRINCIPAL LIFE INSURANCE COMPANY | $19K | $14K | $34K | 7.85% |
| ACRISURE LLC3 | PO BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $13K | $13K | 3.08% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | BLUE CROSS OF CALIFORNIA | $27K | $0 | $27K | 7.34% |
| AMWINS3 Filed as: AMWINS CONNECT INS. SERVICES LLC | 2677 NORTH MAIN STREET SANTA ANA, CA 92705 | BLUE CROSS OF CALIFORNIA | $0 | $16K | $16K | 4.28% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $5K | $0 | $5K | 1.22% |
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 | 0 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 356 | $2.7M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 525 | $430K |
| Vision(2 contracts, 2 carriers) | PRINCIPAL LIFE INSURANCE COMPANY | 525 | $470K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 525 | $430K |
| Long-term disability | PRINCIPAL LIFE INSURANCE COMPANY | 525 | $430K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 356 | $2.7M |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 525 | $430K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 525 | — |
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.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.