| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. SAN JOSE, CA 95112 | BLUE CROSS OF CALIFORNIA | $48K | $2K | $51K | 4.23% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | BLUE CROSS OF CALIFORNIA | $9K | — | $9K | 0.73% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 4.63% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC. | $6K | — | $6K | 4.15% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | GUARDIAN | $18K | $3K | $21K | 15.66% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. SAN JOSE, CA 95112 | DELTA DENTAL OF CALIFORNIA | $12K | — | $12K | 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 | 213 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 128 | $1.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 165 | $124K |
| Vision | GUARDIAN | 213 | $133K |
| Life insurance | GUARDIAN | 213 | $133K |
| Short-term disability | GUARDIAN | 213 | $133K |
| Long-term disability | GUARDIAN | 213 | $133K |
| Prescription drug(4 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 128 | $1.5M |
| Other | GUARDIAN | 213 | $133K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 213 | — |
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.