| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| DH INSURANCE SERVICES3 | 2900 GORDON AVE SUITE 102 SANTA CLARA, CA 95051 | BLUE CROSS OF CALIFORNIA | $23K | — | $23K | 3.51% |
| BEERE & PURVES INC3 Filed as: BEERE & PURVES | 1350 TREAT BLVD. SUITE 470 WALNUT CREEK, CA 94597 | BLUE CROSS OF CALIFORNIA | — | $13K | $13K | 1.96% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | BLUE CROSS OF CALIFORNIA | $9K | — | $9K | 1.39% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $10K | — | $10K | 2.80% |
| DH INSURANCE SERVICES3 | 2900 GORDON AVE SUITE 102 SANTA CLARA, CA 95051 | KAISER FOUNDATION HEALTH PLAN INC. | $9K | — | $9K | 2.57% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SUITE 102 SAN JOSE, CO 95112 | DELTA DENTAL OF CALIFORNIA | $9K | — | $9K | 10.00% |
| DH INSURANCE SERVICES3 | 2900 GORDON AVE SUITE 102 SANTA CLARA, CA 95051 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | — | $4K | 8.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $3K | $556 | $3K | 6.13% |
| DH INSURANCE SERVICES3 | 2727 WALSH AVENUE, SUITE 220 SANTA CLARA, CA 95051 | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY | $601 | — | $601 | 5.69% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY | $268 | — | $268 | 2.54% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 166 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 68 | $993K |
| Dental | DELTA DENTAL OF CALIFORNIA | 127 | $90K |
| Vision | EYEMED VISION CARE - FIDELITY SECURITY LIFE INSURANCE COMPANY | 156 | $11K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $53K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $53K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 58 | $346K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 166 | $53K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.