| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 728 N 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $17K | — | $17K | 9.95% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 N 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $2K | $7K | 14.47% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | $4K | — | $4K | 9.82% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 N 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $566 | $2K | 14.32% |
| MIRIAM F HUNGERFORD3 Filed as: MIRIAM F. HUNGERFORD | 33622 HOLTZ HILL ROAD DANA POINT, CA 92629 | AFLAC | $93 | — | $93 | 4.69% |
| JOY E GUNDERSON3 Filed as: JOY E. GUNDERSON | 4531 VALLECITO LANE YORBA LINDA, CA 92886 | AFLAC | $33 | — | $33 | 1.67% |
| KENNETH FRANCIS O'ROURKE3 | P.O. BOX 1375 PLACENTIA, CA 92871 | AFLAC | $27 | — | $27 | 1.36% |
| DAVID A. BJORKLUND3 | 11 CALLE VECINO SAN CLEMENTE, CA 92673 | AFLAC | $19 | — | $19 | 0.96% |
| SCOTT W BLACKSHEAR3 Filed as: SCOTT W. BLACKSHEAR | 3453 CATHRYN DRIVE COLUMBUS, GA 31906 | AFLAC | $10 | — | $10 | 0.50% |
| BANZAI INSURANCE SOLUTIONS INC3 Filed as: BANZAI INSURANCE SOLUTIONS INC. | 9018 SKYLINE BLVD. OAKLAND, CA 94611 | AFLAC | $2 | — | $2 | 0.10% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 728 N 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $92 | — | $92 | 8.71% |
| DAVID A. RACKLIFFE3 | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $52 | — | $52 | 4.92% |
| MICHAEL F FAHEY III3 Filed as: MICHAEL F. FAHEY III | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $23 | — | $23 | 2.18% |
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 | 377 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 379 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 354 | $174K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY (EYEMED VISION CARE) | 590 | $36K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 377 | $63K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 3 | $3K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 377 | $62K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 590 | — |
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.