| 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 | KAISER FOUNDATION HEALTH PLAN, INC | $13K | — | $13K | 4.60% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N 1ST ST SAN JOSE, CA 95112 | AMERITAS LIFE INSURANCE CORP. | $3K | — | $3K | 7.66% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | AMERITAS LIFE INSURANCE CORP. | $811 | — | $811 | 2.34% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. DBA | FILICE INS AGENCY 738 N 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITEDHEALTHCARE INSURANCE COMPANY | $1K | — | $1K | 14.83% |
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 | 234 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC | 44 | $283K |
| Dental | AMERITAS LIFE INSURANCE CORP. | 167 | $35K |
| Vision | AMERITAS LIFE INSURANCE CORP. | 167 | $35K |
| Life insurance | UNITEDHEALTHCARE INSURANCE COMPANY | 233 | $7K |
| Other | UNITEDHEALTHCARE INSURANCE COMPANY | 233 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 233 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.