| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY Filed as: RON FILICE ENTERPRISES, INC. | 1150 MORAGA WAY MORAGA, CA 94556 | ANTHEM BLUE CROSS | $56K | $564 | $56K | 5.53% |
| AMWINS Filed as: LISI, INC. | 1600 W HILLSDALE BLVD. SAN MATEO, CA 94402 | ANTHEM BLUE CROSS | — | $12K | $12K | 1.16% |
| FILICE INSURANCE AGENCY Filed as: RON FILICE ENTERPRISES, INC. | 738 N FIRST ST SUITE 202 SAN JOSE, CA 95112 | GUARDIAN | $3K | $5K | $8K | 10.01% |
| PACIFIC ADVISORS LLC Filed as: PACIFIC ADVISORS, INC. | 333 N INDIAN HILL BLVD CLAREMONT, CA 91711 | GUARDIAN | $41 | — | $41 | 0.05% |
| PACIFIC ADVISORS LLC | 333 INDIAN HILL BLVD CLAREMONT, CA 91711 | GUARDIAN | $5 | — | $5 | 0.01% |
| FILICE INSURANCE AGENCY Filed as: RON FILICE ENTERPRISES, INC. | 738 N FIRST ST SUITE 202 SAN JOSE, CA 951126371 | UNITED OF OMAHA LIFE INSURANCE COMPANYAN | $3K | $971 | $4K | 19.23% |
| DAVID A. RACKLIFFE Filed as: DAVID A RACKLIFFE | 35 DANBURY LANE IRVINE, CA 92618 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $749 | $62 | $811 | 13.93% |
| FILICE INSURANCE AGENCY Filed as: RON FILICE ENTERPRISES, INC. | 738 N FIRST ST SUITE 202 SAN JOSE, CA 95112 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $299 | $0 | $299 | 5.13% |
| WALTOS INSURANCE SERVICES | 1500 QUAIL ST. NEWPORT BEACH, CA 92660 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $278 | $0 | $278 | 4.77% |
| MICHAEL F FAHEY III | 411 AVENIDA ADOBE SAN CLEMENTE, CA 92672 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $86 | $45 | $131 | 2.25% |
| ASCENSION BENEFITS ADVISORS | 6 POMEGRANATE ST LADERA RANCH, CA 92694 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $71 | $0 | $71 | 1.22% |
| CHARLES DUANCE SMITH | 4040 EAST PIEDMONT DRF HIGHLAND, CA 92346 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $53 | $0 | $53 | 0.91% |
| ADRIAMA MENDIETA | 29448 TOURS STREET LAKE ELSINORE, CA 92530 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $27 | $0 | $27 | 0.46% |
| JOHN D EVANGELISTA | 26111 ANTONIO PARKWAY RANCHO SANTA MARGARITA, CA 92688 | COLONIAL LIFE & ACIDENT INSURANCE COMPANY | $20 | $0 | $20 | 0.34% |
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 | 163 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 163 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 190 | $1.0M |
| Dental | GUARDIAN | 150 | $78K |
| Vision | ANTHEM BLUE CROSS | 190 | $1.0M |
| Life insurance(3 contracts, 3 carriers) | ANTHEM BLUE CROSS | 190 | $1.0M |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANYAN | 46 | $22K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.