| 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 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $49K | $3K | $52K | 9.50% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $8K | $8K | 1.46% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | — | $3K | $3K | 0.63% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $7K | — | $7K | 5.54% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $2K | — | $2K | 10.00% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICES | 32110 AGOURA ROAD WESTLAKE VILLAGE, CA 91361 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | — | $860 | $860 | 4.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNION SECURITY INSURANCE COMPANY | $2K | — | $2K | 21.57% |
| CYNTHIA SMITH3 | 6329 FARM HILL WAY SAN JOSE, CA 95120 | UNION SECURITY INSURANCE COMPANY | — | $258 | $258 | 2.84% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNION SECURITY INSURANCE COMPANY | $1K | — | $1K | 21.58% |
| CYNTHIA SMITH3 | 6329 FARM HILL WAY SAN JOSE, CA 95120 | UNION SECURITY INSURANCE COMPANY | — | $133 | $133 | 2.84% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNION SECURITY INSURANCE COMPANY | $328 | $103 | $431 | 13.05% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNION SECURITY INSURANCE COMPANY | $498 | — | $498 | 21.40% |
| CYNTHIA SMITH3 | 6329 FARM HILL WAY SAN JOSE, CA 95120 | UNION SECURITY INSURANCE COMPANY | — | $59 | $59 | 2.54% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNION SECURITY INSURANCE COMPANY | $286 | — | $286 | 21.55% |
| CYNTHIA SMITH3 | 6329 FARM HILL WAY SAN JOSE, CA 95120 | UNION SECURITY INSURANCE COMPANY | — | $38 | $38 | 2.86% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNION SECURITY INSURANCE COMPANY | $158 | — | $158 | 21.38% |
| CYNTHIA SMITH3 | 6329 FARM HILL WAY SAN JOSE, CA 95120 | UNION SECURITY INSURANCE COMPANY | — | $18 | $18 | 2.44% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INSURANCE CO EIN 59-1031071 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | — | $28K |
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 | 150 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 150 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 182 | $673K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 182 | $564K |
| Vision(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 182 | $546K |
| Short-term disability | UNION SECURITY INSURANCE COMPANY | 8 | $2K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 20 | $130K |
| Other(4 contracts) | UNION SECURITY INSURANCE COMPANY | 31 | $16K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 182 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.