| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | AETNA LIFE INSURANCE COMPANY | $66K | $0 | $66K | 4.99% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $6K | $149 | $6K | 3.37% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1123 CHERRY AVENUE SAN JOSE, CA 95125 | KAISER FOUNDATION HEALTH PLAN INC | $4K | $0 | $4K | 2.19% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 7.01% |
| FILICE INSURANCE AGENCY3 Filed as: RON FLICE ENTERPRISES | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $670 | $2K | 4.14% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $0 | $1K | 2.94% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $1K | $0 | $1K | 5.90% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $982 | $0 | $982 | 4.05% |
| JOSHUA BALTOR3 Filed as: JOSHUA S. BALTOR | 1020 MERNER ROAD HILLSBOROUGH, CA 94010 | AFLAC | $375 | $0 | $375 | 5.54% |
| BALTOR INSURANCE SERVICES3 | 1020 MERNER ROAD HILLSBOROUGH, CA 94010 | AFLAC | $338 | $0 | $338 | 4.99% |
| MJ INSURANCE3 Filed as: MELANIE BRUBAKER AND VARIOUS AGENTS | 30 PHILADELPHIA DRIVE, SUITE D CHICO, CA 95973 | AFLAC | $250 | $0 | $250 | 3.69% |
| RUBEN ROSA3 | 5307 SEPULVEDA BOULEVARD APARTMENT 118 SHERMAN OAKS, CA 91411 | AFLAC | $84 | $0 | $84 | 1.24% |
| MATTHEW SHINE3 | 155 WEST SANTA CLARA STREET APARTMENT 215 SAN JOSE, CA 95113 | AFLAC | $66 | $0 | $66 | 0.98% |
| BONNIE C. SATO3 | 2515 MUIRFIELD WAY GILROY, CA 95020 | AFLAC | $54 | $0 | $54 | 0.80% |
| SHELLY DENISE CAIRES3 | 220 CASCADE DRIVE HIGH POINT, NC 27265 | AFLAC | $52 | $0 | $52 | 0.77% |
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 | 100 | 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) | 100 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 142 | $1.5M |
| Dental | AFLAC | 9 | $7K |
| Vision | VISION SERVICE PLAN | 91 | $24K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $43K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $43K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 142 | $1.5M |
| Other(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 100 | $49K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.