| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES 1950 W CORPORATE WAY #33276 ANAHEIM, CA 92801 | UNITEDHEALTHCARE INSURANCE COMPANY | $61K | — | $61K | 4.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITEDHEALTHCARE INSURANCE COMPANY | $22K | — | $22K | 1.42% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $13K | — | $13K | 5.32% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $16K | $1K | $17K | 12.14% |
| LUMITY, INC.3 Filed as: LUMITY INC | 71 E 3RD AVE SAN MATEO, CA 94401 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $123 | $123 | 0.09% |
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 | 197 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 202 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 234 | $1.8M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 197 | $140K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 197 | $140K |
| Short-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 197 | $140K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 197 | $140K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 35 | $242K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 197 | $140K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 234 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.