| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | PO BOX 3900 SAN FRANCISCO, CA 94139 | AETNA LIFE INSURANCE COMPANY | $31K | — | $31K | 3.10% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | AETNA LIFE INSURANCE COMPANY | $22K | — | $22K | 2.13% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GROUP, INC. | 5110 NORTH 40TH STREET, SUITE 234 PHOENIX, AZ 85018 | PRINCIPAL LIFE INSURANCE COMPANY | $4K | — | $4K | 2.86% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | PRINCIPAL LIFE INSURANCE COMPANY | $1K | $801 | $2K | 1.65% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 10 SOUTH WACKER DRIVE, 17TH FLOOR CHICAGO, IL 60606 | PRINCIPAL LIFE INSURANCE COMPANY | — | $585 | $585 | 0.48% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $763 | — | $763 | 4.82% |
| WELLS FARGO INSURANCE SERVICES3 Filed as: WELLS FARGO INSURANCE SERVICES USA | 959 SKYWAY ROAD, SUITE 200 SAN CARLOS, CA 94070 | VISION SERVICE PLAN | $424 | — | $424 | 2.68% |
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 | 160 | 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) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | AETNA LIFE INSURANCE COMPANY | 160 | $1.0M |
| Dental | PRINCIPAL LIFE INSURANCE COMPANY | 156 | $123K |
| Vision | VISION SERVICE PLAN | 89 | $16K |
| Life insurance | AETNA LIFE INSURANCE COMPANY | 160 | $1.0M |
| Short-term disability | AETNA LIFE INSURANCE COMPANY | 160 | $1.0M |
| Long-term disability | AETNA LIFE INSURANCE COMPANY | 160 | $1.0M |
| Other | AETNA LIFE INSURANCE COMPANY | 160 | $1.0M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.