| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PACIFIC COAST BENEFITS, LLC3 | 7600 MONTEREY STREET GILROY, CA 95020 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $24K | — | $24K | 2.00% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $5K | — | $5K | 0.38% |
| PACIFIC COAST BENEFITS, LLC3 | P.O. BOX 1749 GILROY, CA 95021 | KAISER FOUNDATION HEALTH PLAN INC. | $22K | — | $22K | 4.41% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $5K | $5 | $5K | 0.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | — | $697 | $697 | 0.14% |
| PACIFIC COAST BENEFITS, LLC3 | P.O. BOX 1749 GILROY, CA 95021 | ANTHEM BLUE CROSS | $8K | — | $8K | 4.24% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | ANTHEM BLUE CROSS | $878 | — | $878 | 0.45% |
| PACIFIC COAST BENEFITS, LLC3 | P.O. BOX 1749 GILROY, CA 95021 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | — | $3K | 5.13% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $245 | — | $245 | 0.49% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | KAISER FOUNDATION HEALTH PLAN INC. | — | $66 | $66 | 0.13% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $10K | $606 | $11K | 32.66% |
| AMWINS3 Filed as: LISI INC. | 1600 W. HILLSDALE BLVD. SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 9.19% |
| PACIFIC COAST BENEFITS, LLC3 | P.O. BOX 1749 GILROY, CA 95021 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 8.71% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: HUB INTERNATIONAL INSURANCE SERVICE | P.O. BOX 2158 RIVERSIDE, CA 92516 | METROPOLITAN LIFE INSURANCE COMPANY | $683 | $273 | $956 | 3.03% |
| PACIFIC DIVERSIFIED INS. SERVICES3 Filed as: PACIFIC DIVERSIFIED INSURANCE | 15005 CONCORD CIRCLE MORGAN HILL, CA 95037 | METROPOLITAN LIFE INSURANCE COMPANY | $298 | — | $298 | 0.94% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $6K | $265 | $6K | 21.24% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $1K | $56 | $1K | 21.93% |
| COLONIAL LIFE & ACCIDENT3 | P.O. BOX 1365 COLUMBIA, SC 29202 | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | $149 | $17 | $166 | 42.35% |
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 | 621 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 626 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 626 | $738K |
| Dental(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 622 | $1.2M |
| Vision | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 560 | $1.2M |
| Life insurance(5 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 622 | $100K |
| Short-term disability(4 contracts) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 33 | $68K |
| Prescription drug(4 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 626 | $1.9M |
| Stop-loss / reinsurancereinsurance | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 560 | $1.2M |
| Other(5 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 622 | $100K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 626 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.