| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH 1ST STREET SAN JOSE, CA 95112 | AETNA LIFE INSURANCE COMPANY | $32K | $2K | $34K | 2.76% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | AETNA LIFE INSURANCE COMPANY | $20K | $0 | $20K | 1.60% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 333 EAST OSBORN ROAD, SUITE 270 PHOENIX, AZ 85012 | AETNA LIFE INSURANCE COMPANY | $10K | $0 | $10K | 0.83% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2121 NORTH CALIFORNIA BOULEVARD SUITE 350 WALNUT CREEK, CA 94596 | KAISER FOUNDATION HEALTH PLAN INC | $7K | $0 | $7K | 2.45% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $5K | $116 | $5K | 1.68% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH 1ST STREET SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $3K | $4K | 9.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD ROLLING MEADOWS, IL 60008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 8.68% |
| GALLAGHER BENEFIT SERVICES, INC.3 | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.25% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $996 | $0 | $996 | 4.02% |
| BALTOR INSURANCE SERVICES3 | 1020 MERNER ROAD HILLSBOROUGH, CA 94010 | AFLAC | $1K | $0 | $1K | 11.06% |
| JOSHUA BALTOR3 Filed as: JOSHUA S. BALTOR | 1020 MERNER ROAD HILLSBOROUGH, CA 94010 | AFLAC | $575 | $0 | $575 | 5.11% |
| MELAINE BRUBAKER AND OTHER AGENTS3 | 3221 COHASSETT ROAD, SUITE 130 CHICO, CA 95973 | AFLAC | $349 | $0 | $349 | 3.10% |
| REUBEN ROSA3 | 5307 SEPULVEDA BOULEVARD APARTMENT 118 SHERMAN OAKS, CA 91411 | AFLAC | $132 | $0 | $132 | 1.17% |
| MATTHEW SHINE3 | 111 LLANO DE LOS ROBLES AVENUE SAN JOSE, CA 95136 | AFLAC | $66 | $0 | $66 | 0.59% |
| BONNIE C. SATO3 | 2515 MUIRFIELD WAY GILROY, CA 95020 | AFLAC | $54 | $0 | $54 | 0.48% |
| SHELLY DENISE CAIRES3 | 220 CASCADE DRIVE HIGHPOINT, NC 27265 | AFLAC | $50 | $0 | $50 | 0.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 1255 BATTERY STREET, SUITE 450 SAN FRANCISCO, CA 94111 | CLAREMONT BEHAVIORAL SERVICES, INC. | $35 | $0 | $35 | 0.83% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 116 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 139 | $1.5M |
| Dental | AFLAC | 9 | $11K |
| Vision | VISION SERVICE PLAN | 103 | $25K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $48K |
| Short-term disability(2 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $60K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $48K |
| Prescription drug(2 contracts, 2 carriers) | AETNA LIFE INSURANCE COMPANY | 139 | $1.5M |
| Other(3 contracts, 3 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 112 | $64K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 139 | — |
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.