| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | CALIFORNIA PHYSICIANS' SERVICE | $86K | $86 | $86K | 5.00% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $13K | — | $13K | 4.67% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER & COMPANY | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | KAISER FOUNDATION HEALTH PLAN INC | $2K | — | $2K | 0.56% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $1K | — | $1K | 2.75% |
| WOODRUFF-SAWYER & CO3 Filed as: WOODRUFF-SAWYER AND COMPANY | 50 CALIFORNIA STREET, FLOOR 12 SAN FRANCISCO, CA 94111 | VISION SERVICE PLAN | $472 | — | $472 | 0.92% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 4.86% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | — | $1K | 7.02% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $2K | — | $2K | 10.65% |
| RHONA S UNSELL INC4 Filed as: RHONA S. UNSELL, INC. | SUITE 370-152 6525 GUNPARK DRIVE BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $2K | — | $2K | 21.57% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH, PA | $256 | — | $256 | 15.02% |
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 | 108 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 7 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 115 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 441 | $2.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 196 | $241K |
| Vision | VISION SERVICE PLAN | 196 | $52K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 218 | $28K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 218 | $18K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 218 | $15K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 441 | $1.7M |
| Other(3 contracts, 3 carriers) | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | 280 | $23K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 441 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.