| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WESTCORP FINANCIAL SERVICES3 Filed as: WESTCORP FINANCIAL & INS SVCS | 110 BLUE RAVINE RD 158 FOLSOM, CA 95630 | CALIFORNIA PHYSICIANS' SERVICE | — | $35K | $35K | 5.32% |
| AMWINS3 Filed as: LISI, INC | 1600 W HILLSDALE BLVD SUITE 201 SAN MATEO, CA 94402 | CALIFORNIA PHYSICIANS' SERVICE | $14K | — | $14K | 2.11% |
| WESTCORP FINANCIAL SERVICES3 | 110 BLUE RAVINE RD STE 158 FOLSOM, CA 95630 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 4.17% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $3K | — | $3K | 0.82% |
| WESTCORP FINANCIAL SERVICES3 | 110 BLUE RAVINE RD STE 158 FOLSOM, CA 95630 | KAISER FOUNDATION HEALTH PLAN INC | $9K | — | $9K | 5.37% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $8K | — | $8K | 4.58% |
| ALEXIS NICOLE DEVORSS3 | 110 BLUE RAVINE RD STE 1 FOLSOM, CA 95630 | PRINCIPAL LIFE INSURANCE COMPANY | $2K | — | $2K | 7.13% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 5738 N 1ST ST SAN JOSE, CA 95112 | PRINCIPAL LIFE INSURANCE COMPANY | $549 | — | $549 | 1.88% |
| WESTCORP FINANCIAL SERVICES3 Filed as: WESTCORP FINANCIAL SERVICES, INC | 110 BLUE RAVINE RD STE 158 FOLSOM, CA 95630 | VISION SERVICE PLAN | $828 | — | $828 | 5.20% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $380 | — | $380 | 2.39% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA EASECENTRAL | 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $48 | — | $48 | 0.30% |
| WESTCORP FINANCIAL SERVICES3 Filed as: WESTCORP FINANCIAL SERVICES INC | 110 BLUE RAVINE RD STE 158 FOLSOM, CA 95630 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $1K | — | $1K | 11.18% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NO 1ST STREET SUITE 202 SAN JOSE, CA 95112 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $408 | — | $408 | 3.52% |
| WESTCORP FINANCIAL SERVICES3 Filed as: WESTCORP FINANCIAL SVCS INC | 110 BLUE RAVINE RD 158 FOLSOM, CA 95630 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 76.80% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST ST STE 202 SAN JOSE, CA 95112 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 23.20% |
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 | 94 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 94 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | CALIFORNIA PHYSICIANS' SERVICE | 94 | $1.2M |
| Dental | DELTA DENTAL OF CALIFORNIA | 198 | $11K |
| Vision | VISION SERVICE PLAN | 94 | $16K |
| Life insurance | PRINCIPAL LIFE INSURANCE COMPANY | 146 | $29K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 94 | $12K |
| Prescription drug | CALIFORNIA PHYSICIANS' SERVICE | 94 | $658K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 198 | — |
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.