| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES LLC 3155 OLSEN DRIVE SAN JOSE, CA 95117 | BLUE SHIELD OF CALIFORNIA-CALIFORNIA PHYSICIANS' SERVICE | $7K | $18K | $26K | 1.43% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | BLUE SHIELD OF CALIFORNIA-CALIFORNIA PHYSICIANS' SERVICE | $2K | $5K | $8K | 0.43% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | BLUE SHIELD OF CALIFORNIA-CALIFORNIA PHYSICIANS' SERVICE | — | $2K | $2K | 0.13% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $12K | $1 | $12K | 0.93% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 0.64% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $1K | — | $1K | 4.44% |
| ENROLLEASE3 Filed as: ENROLLEASE, INC DBA EASECENTRAL | 1980 FESTIVAL PLAZA DR STE 810 LAS VEGAS, NV 89135 | VISION SERVICE PLAN | $2 | — | $2 | 0.01% |
| ACRISURE LLC3 Filed as: ACRISURE PTNRS WEST COAST INS SVCS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
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 | 204 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 204 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA-CALIFORNIA PHYSICIANS' SERVICE | 174 | $3.0M |
| Dental | BLUE SHIELD OF CALIFORNIA-CALIFORNIA PHYSICIANS' SERVICE | 174 | $1.8M |
| Vision | VISION SERVICE PLAN | 188 | $34K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 204 | $12K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 204 | $53K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 204 | $41K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA-CALIFORNIA PHYSICIANS' SERVICE | 174 | $1.8M |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 204 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 204 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.