| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $175K | — | $175K | 3.67% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WESTCOAST INSURAN | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $63K | — | $63K | 1.31% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | BLUE CROSS OF CALIFORNIA | $1K | $6K | $7K | 0.15% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $58K | — | $58K | 4.02% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $11K | $14K | 6.17% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 1.69% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $4K | $9K | 12.38% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 3.61% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $4K | $8K | 10.26% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 2.80% |
| ACRISURE LLC3 Filed as: ACRISURE NORTHWEST PARTNERS INS | 40TH AVE W SUITE 440 LYNNWOOD, WA 98036 | AMERICAN HERITAGE LIFE INSURANCE COMPANY | $1K | — | $1K | 3.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE, SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $3K | — | $3K | 6.47% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE CAMPBELL, CA 95008 | VISION SERVICE PLAN | $1K | — | $1K | 3.22% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 N FIRST ST STE 210 SAN JOSE, CA 95112 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH | $5K | — | $5K | 15.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 11.68% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $822 | — | $822 | 3.36% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $3K | 12.48% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $693 | — | $693 | 3.32% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $922 | $2K | 11.45% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $650 | — | $650 | 3.47% |
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 | 419 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 420 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 491 | $6.2M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 756 | $520K |
| Vision | VISION SERVICE PLAN | 301 | $42K |
| Life insurance(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 421 | $340K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 421 | $19K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 421 | $73K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 151 | $1.4M |
| Other(4 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 421 | $297K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 756 | — |
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."
No prospect flags tripped on this filing.