| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FLICE INSURANCE AGENCY | 1150 MORAGA WAY MORAGA, CA 94556 | SUTTER HEALTH PLUS | $14K | $0 | $14K | 3.38% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | SUTTER HEALTH PLUS | $7K | $0 | $7K | 1.62% |
| FILICE INSURANCE AGENCY3 Filed as: FLICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | $0 | $4K | 2.54% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET 52ND FLOOR LOS ANGELES, CA 90017 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $0 | $2K | 0.98% |
| FILICE INSURANCE AGENCY3 Filed as: FLICE INSURANCE SERVICES, LLC | 738 NORTH 1ST STREET SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $7K | $0 | $7K | 4.62% |
| FILICE INSURANCE AGENCY3 Filed as: FLICE INSURANCE SERVICES, LLC | 900 EAST HAMILTON AVENUE, SUITE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $5K | 5.84% |
| LOCKTON COMPANIES, LLC3 | 777 SOUTH FIGUEROA STREET SUITE 5200 LOS ANGELES, CA 90017 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $642 | $0 | $642 | 0.72% |
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 | 104 | 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) | 104 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | SUTTER HEALTH PLUS | 54 | $707K |
| Dental | UNITED OF OMAHA LIFE INSURANCE COMPANY | 109 | $89K |
| Prescription drug(3 contracts, 3 carriers) | SUTTER HEALTH PLUS | 54 | $707K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 109 | — |
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.