| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE OF CA | 3697 MT. DIABLO BLVD., SUITE 100 LAFAYETTE, CA 94549 | KAISER FOUNDATION HEALTH PLAN INC. | $19K | — | $19K | 1.61% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $11K | — | $11K | 0.95% |
| PLEASANTON VALLEY INSURANCE3 Filed as: PLEASANTON VALLEY INSURANCE BROKERS | 6602 OWENS DRIVE, SUITE 200 PLEASANTON, CA 94588 | KAISER FOUNDATION HEALTH PLAN INC. | $7K | — | $7K | 0.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS. OF CA | 3697 MT. DIABLO BLVD., SUITE 100 LAFAYETTE, CA 94549 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $43 | $6K | 5.93% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 2.42% |
| PLEASANTON VALLEY INSURANCE3 Filed as: PLEASANTON VALLEY INSURANCE BROKERS | 6602 OWENS DRIVE, SUITE 200 PLEASANTON, CA 94588 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 1.62% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS. OF CA | ONE KAISER PLAZA, SUITE 1101 OAKLAND, CA 94612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 8.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 4.20% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS. OF CA | 3697 MT. DIABLO BLVD., SUITE 100 LAFAYETTE, CA 94549 | SAFEGUARD HEALTH PLANS, INC. | $2K | $11 | $2K | 5.91% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | SAFEGUARD HEALTH PLANS, INC. | $659 | — | $659 | 2.50% |
| PLEASANTON VALLEY INSURANCE3 Filed as: PLEASANTON VALLEY INSURANCE BROKERS | 6602 OWENS DRIVE, SUITE 200 PLEASANTON, CA 94588 | SAFEGUARD HEALTH PLANS, INC. | $439 | — | $439 | 1.67% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $725 | — | $725 | 2.98% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS. OF CA | ONE KAISER PLAZA, SUITE 1101 OAKLAND, CA 94612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $2K | — | $2K | 11.26% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $435 | — | $435 | 2.24% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS. OF CA | ONE KAISER PLAZA, SUITE 1101 OAKLAND, CA 94612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 8.14% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $646 | — | $646 | 4.11% |
| SITZMANN MORRIS & LAVIS, INC.3 Filed as: SITZMANN, MORRIS & LAVIS | ONE KAISER PLAZA, SUITE 1101 OAKLAND, CA 94612 | CLAREMONT EAP | $599 | — | $599 | 4.76% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS. SVCS. OF CA | ONE KAISER PLAZA, SUITE 1101 OAKLAND, CA 94612 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $647 | — | $647 | 8.20% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $322 | — | $322 | 4.08% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 230 | $1.2M |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 114 | $134K |
| Vision | VISION SERVICE PLAN | 118 | $24K |
| Life insurance(2 contracts) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 119 | $53K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 119 | $8K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 120 | $16K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 230 | $1.2M |
| Other(2 contracts, 2 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 142 | $46K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 230 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.