| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC | 738 N. FIRST ST SAN JOSE, CA 95112 | BLUE SHIELD OF CALIFORNIA CALIFORNIA PHYSICIANS' SERVICE | $50K | — | $50K | 2.89% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC | 738 N. FIRST ST SAN JOSE, CA 95112 | SUN LIFE ASSURANCE COMPANY OF CANADA | $4K | — | $4K | 4.93% |
| PERFORMANCE INSURANCE BENEFITS3 Filed as: PERFORMANCE INSURANCE BENEFITS INC | 20827 N CAVE CREEK RD STE 102 PHOENIX, AZ 85024 | SUN LIFE ASSURANCE COMPANY OF CANADA | $3K | — | $3K | 3.49% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST ST SAN JOSE, CA 95112 | KAISER PERMANENTE | $4K | — | $4K | 5.28% |
| DARREN MICHAEL GRIFFITH3 | 20827 N CAVE CREEK RD STE 102 PHOENIX, AZ 85024 | KAISER PERMANENTE | $414 | — | $414 | 0.57% |
| PERFORMANCE INSURANCE BENEFITS3 Filed as: PERFORMANCE INSURANCE BENEFITS INC | 20827 N CAVE CREEK RD STE 102 PHOENIX, AZ 85024 | VISION SERVICE PLAN | $329 | — | $329 | 0.85% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC | 738 N. FIRST ST SAN JOSE, CA 95112 | ALLSTATE - AMERICAN HERITAGE LIFE INSURANCE COMPANY | $2K | — | $2K | 25.00% |
| RHONA S UNSELL INC4 Filed as: RHONA S. UNSELL INC. | SUITE 370-152 6525 GUNPARK DR BOULDER, CO 80301 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $1K | — | $1K | 34.60% |
| PERFORMANCE INSURANCE BENEFITS4 | SUITE 102 20827 N. CAVE CREEK RD PHOENIX, AZ 85024 | PRE-PAID LEGAL SERVICES, INC. DBA LEGALSHIELD | $23 | — | $23 | 0.60% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 12 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 154 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | BLUE SHIELD OF CALIFORNIA CALIFORNIA PHYSICIANS' SERVICE | 110 | $1.8M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 125 | $166K |
| Vision | VISION SERVICE PLAN | 120 | $39K |
| Life insurance | SUN LIFE ASSURANCE COMPANY OF CANADA | 142 | $86K |
| Short-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 142 | $86K |
| Long-term disability | SUN LIFE ASSURANCE COMPANY OF CANADA | 142 | $86K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA CALIFORNIA PHYSICIANS' SERVICE | 110 | $1.7M |
| Other(3 contracts, 3 carriers) | SUN LIFE ASSURANCE COMPANY OF CANADA | 147 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.