| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNITEDHEALTHCARE INSURANCE COMPANY | $78K | — | $78K | 5.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $18K | $2 | $18K | 4.84% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $174 | $12K | 10.18% |
| ROGERS BENEFIT GROUP INC3 Filed as: ROGERS BENEFIT GRP., INC. | 5110 N 40TH ST., #234 PHOENIX, AZ 850182151 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $555 | $3K | 2.69% |
| 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 | $4K | $785 | $5K | 13.53% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | EYE MED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $2K | — | $2K | 11.05% |
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 | 336 | 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) | 336 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 125 | $1.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 336 | $122K |
| Vision | EYE MED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 239 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 233 | $36K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 233 | $36K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 43 | $373K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 233 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 336 | — |
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.