| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 738 NORTH 1ST STREET SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $36K | $5 | $36K | 2.75% |
| PLEASANTON VALLEY INSURANCE3 Filed as: PLEASANTON VALLEY INSURANCE BROKERS | 6602 OWENS DRIVE SUITE 200 PLEASANTON, CA 94588 | KAISER FOUNDATION HEALTH PLAN INC | $24K | $0 | $24K | 1.83% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STREET SUITE 202 SAN JOSE, CA 95112 | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | $11K | $0 | $11K | 10.01% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STREET SUITE 202 SAN JOSE, CA 95112 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $7K | $874 | $7K | 10.19% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 NORTH 1ST STREET SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $2K | $0 | $2K | 6.00% |
| PLEASANTON VALLEY INSURANCE3 | 6602 OWENS DRIVE SUITE 200 PLEASANTON, CA 94588 | VISION SERVICE PLAN | $1K | $0 | $1K | 4.00% |
| RONALD E. HENDRICKSON3 | 973 SPRINGVIEW CIRCLE SAN RAMON, CA 94583 | AFLAC | $648 | $0 | $648 | 3.65% |
| MJ INSURANCE3 Filed as: JUSTIN REYNOLDS AND VARIOUS AGENTS | 8433 ENTERPRISE CIRCLE SUITE 100 LAKEWOOD RANCH, FL 34202 | AFLAC | $626 | $0 | $626 | 3.53% |
| CHARLES G WENDELBERGER3 Filed as: CHARLES G. WENDELBERGER | 207 SANTA FE DRIVE WALNUT CREEK, CA 94598 | AFLAC | $250 | $0 | $250 | 1.41% |
| MINES INSURANCE SERVICES INC3 Filed as: MINES INSURANCE SERVICES, INC. | 1519 BARTH AVENUE RICHMOND, CA 94806 | AFLAC | $214 | $0 | $214 | 1.21% |
| RANDALL D LADNER3 Filed as: RANDALL C. NORRIS | 23 RIDGEVIEW COURT SAN RAMON, CA 94582 | AFLAC | $110 | $0 | $110 | 0.62% |
| JONATHAN ALI HAJIMOMEN3 Filed as: JONATHAN DANIEL PAYNE | 3572 SHADOWTREE LANE CHICO, CA 95928 | AFLAC | $106 | $0 | $106 | 0.60% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN INS. SVCS. OF CA | 1 KAISER PLAZA SUITE 1101 OAKLAND, CA 94612 | AFLAC | $106 | $0 | $106 | 0.60% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET SUITE 202 SAN JOSE, CA 95112 | CLAREMONT EAP | $597 | $0 | $597 | 5.00% |
| WAYNE RIMMER3 Filed as: WAYNE P. SMITH | 1113 WEST GROVE WAY COEUR D ALENE, ID 83815 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $66 | $0 | $66 | 1.05% |
| G SCOTT COOKE3 Filed as: SCOTT ALLEN BEER | 8385 NORTH RAISINA AVENUE FRESNO, CA 93720 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $48 | $0 | $48 | 0.76% |
| HOLLERN & ASSOCIATES INCORPORATED3 Filed as: HOLLERN & ASSOCIATES, INCORPORATED | 11412 ROBBIA DRIVE LAS VEGAS, NV 89138 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $9 | $0 | $9 | 0.14% |
| CHRISTINA MARIE ALTOMARE3 | 1692 CRESCENT DRIVE WALNUT CREEK, CA 94598 | COLONIAL LIFE AND ACCIDENT INSURANCE COMPANY | $1 | $0 | $1 | 0.02% |
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 | 122 | 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) | 122 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC | 241 | $1.3M |
| Dental(2 contracts, 2 carriers) | UNITED CONCORDIA DENTAL PLANS OF CALIFORNIA, INC. | 236 | $130K |
| Vision | VISION SERVICE PLAN | 122 | $25K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $74K |
| Short-term disability(3 contracts, 3 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $98K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 122 | $74K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 241 | $1.3M |
| Other(4 contracts, 4 carriers) | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 141 | $109K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 241 | — |
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.