| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $72K | — | $72K | 3.35% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $35K | — | $35K | 3.99% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED HEALTHCARE INSURANCE COMPANY | $16K | — | $16K | 3.35% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP | 7310 N 16TH STREET PHOENIX, AZ 85020 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 1.67% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS SERVICE | $7K | — | $7K | 5.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: RBG SAN JOSE | 6155 ALMADEN EXPY, SUITE 210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS SERVICE | — | $6K | $6K | 4.61% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS SERVICE | $7K | — | $7K | 5.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: RBG SAN JOSE | 6155 ALMADEN EXPY, SUITE 210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS SERVICE | — | $3K | $3K | 2.50% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | WESTERN HEALTH ADVANTAGE | $5K | — | $5K | 3.60% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS SERVICE | $6K | — | $6K | 5.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: RBG SAN JOSE | 6155 ALMADEN EXPY, SUITE 210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS SERVICE | — | $2K | $2K | 2.00% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS SERVICE | $5K | — | $5K | 5.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: RBG SAN JOSE | 6155 ALMADEN EXPY, SUITE 210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS SERVICE | — | $2K | $2K | 2.50% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | — | $5K | 5.73% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS SERVICE | $4K | — | $4K | 5.00% |
| ROGERS BENEFIT GROUP INC3 Filed as: RBG SAN JOSE | 6155 ALMADEN EXPY, SUITE 210 SAN JOSE, CA 95120 | CALIFORNIA PHYSICIANS SERVICE | — | $2K | $2K | 2.50% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 4.66% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | PRINCIPAL LIFE INSURANCE COMPANY | $5K | $815 | $6K | 12.44% |
| ACRISURE LLC3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $443 | $443 | 0.90% |
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 | 842 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 15 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 857 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(11 contracts, 5 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 329 | $4.3M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 842 | $49K |
| Prescription drug(9 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 329 | $3.8M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 842 | — |
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."
Multiple-employer welfare arrangement. Specific regulatory and compliance context; specific consultant niche.