| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 1950 W. CORPORATE WAY #33276 ANAHEIM, CA 92801 | UNITED HEALTHCARE INSURANCE COMPANY | $178K | — | $178K | 2.12% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 1950 W. CORPORATE WAY #33276 ANAHEIM, CA 92801 | UNITED HEALTHCARE INSURANCE COMPANY | $62K | — | $62K | 0.74% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | — | $2K | $2K | 0.07% |
| FILICE INSURANCE AGENCY3 | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLANS, INC. | $35K | — | $35K | 2.81% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $32K | — | $32K | 5.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $11K | — | $11K | 8.32% |
| FILICE INSURANCE AGENCY3 | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $2K | — | $2K | 1.79% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | CONTINENTAL AMERICAN INSURANCE COMPANY | $34K | — | $34K | 58.79% |
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 | 768 | 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) | 768 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 1,557 | $13.0M |
| Dental | UNITED HEALTHCARE INSURANCE COMPANY | 1,557 | $8.4M |
| Vision | VISION SERVICE PLAN | 611 | $129K |
| Life insurance(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 768 | $702K |
| Short-term disability(2 contracts, 2 carriers) | STANDARD INSURANCE COMPANY | 768 | $702K |
| Long-term disability | STANDARD INSURANCE COMPANY | 726 | $644K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | 458 | $4.6M |
| Other | CONTINENTAL AMERICAN INSURANCE COMPANY | 768 | $58K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,557 | — |
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.