| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | CALIFORNIA PHYSICIANS SERVICE | $0 | $27K | $27K | 4.46% |
| AMWINS3 Filed as: AMWINS CONNECT INSURANCE SERVICES | 1600 WEST HILLSDALE BOULEVARD SUITE 201 SAN MATEO, CA 94403 | CALIFORNIA PHYSICIANS SERVICE | $0 | $10K | $10K | 1.62% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $19K | $0 | $19K | 5.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $11K | $0 | $11K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $869 | $6K | 15.79% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $2K | $0 | $2K | 10.00% |
| ENROLLEASE3 Filed as: ENROLLEASE INC | 1980 FESTIVAL PLAZA DRIVE SUITE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $188 | $0 | $188 | 1.25% |
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 | 110 | 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) | 110 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 104 | $992K |
| Dental | DELTA DENTAL OF CALIFORNIA | 209 | $106K |
| Vision | VISION SERVICE PLAN | 99 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $39K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $39K |
| Prescription drug(2 contracts, 2 carriers) | CALIFORNIA PHYSICIANS SERVICE | 104 | $992K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 110 | $39K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 209 | — |
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.