| 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 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $24K | $5K | $28K | 12.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $22K | — | $22K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E. HAMILTON AVE CAMPBELL, CA 95008 | VISION SERVICE PLAN | $7K | — | $7K | 10.02% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $982 | $6K | 12.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| O'HARA, CASSIDY E3 Filed as: O'HARA, CASSIDY, EVAN | 738 N FIRST ST STE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $103 | — | $103 | 11.08% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $36 | — | $36 | 3.87% |
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 | 259 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 262 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 637 | $2.8M |
| Dental | STANDARD INSURANCE COMPANY | 238 | $217K |
| Vision(2 contracts, 2 carriers) | VISION SERVICE PLAN | 238 | $78K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $285K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $235K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $235K |
| Prescription drug | BLUE CROSS AND BLUE SHIELD OF ALABAMA | 637 | $2.8M |
| Other(3 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 256 | $285K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 637 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.