| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $92K | $4 | $92K | 3.80% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | SUTTER HEALTH PLAN | $37K | — | $37K | 4.00% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | AETNA LIFE INSURANCE COMPANY | $42K | $3K | $45K | 4.89% |
| GREGORY ALBIN3 | 2010 CROWN CANYON SAN RAMON, CA 94583 | WESTERN HEALTH ADVANTAGE | $6K | — | $6K | 3.60% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | PRINCIPAL LIFE INSURANCE COMPANY | $6K | — | $6K | 11.30% |
| ACRISURE LLC3 | P.O. BOX 1788 GRAND RAPIDS, MI 49501 | PRINCIPAL LIFE INSURANCE COMPANY | — | $271 | $271 | 0.54% |
| REMMEL SOLUTIONS3 | 1183 SWALLOWTAIL WAY NIPOMO, CA 93444 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $984 | — | $984 | 26.37% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $671 | — | $671 | 17.98% |
| CROUSE COMPANY LLC3 | 601 REDLEAD RIDGE NASHVILLE, TN 37211 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $197 | — | $197 | 5.28% |
| SUSAN RIEN3 | 5137 GREENBERRY DRIVE SACRAMENTO, CA 95741 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $43 | — | $43 | 1.15% |
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 | 697 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 701 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 295 | $4.4M |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 697 | $50K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 295 | $4.4M |
| Other | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 30 | $4K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 697 | — |
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.