| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITEDHEALTHCARE INSURANCE COMPANY | $4K | — | $4K | 6.98% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 4.81% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RON FILICE ENTERPRISES, INC BROKER | Insurance agents and brokers Service code 22 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | $21K |
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 | 499 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 505 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 745 | $592K |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 745 | $552K |
| Vision | UNITEDHEALTHCARE INSURANCE COMPANY | 745 | $552K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 645 | $52K |
| Short-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 645 | $52K |
| Long-term disability | UNITEDHEALTHCARE INSURANCE COMPANY | 645 | $52K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 50 | $41K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 645 | $52K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 745 | — |
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."
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.