| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $12K | $12K | 2.44% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH CUSTOM BEN | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 1.87% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: WELLS FARGO INS SVCS USA, INC | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $627 | $0 | $627 | 0.75% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS, INC | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | — | $593 | $593 | 0.71% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $404 | — | $404 | 0.48% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH & BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $358 | — | $358 | 0.43% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | — | $4 | 0.00% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP, INC | 1152 RANCH POINT WAY ANTIOCH, CA 94531 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $9K | — | $9K | 22.77% |
| GRACE S. COTA4 | 9130 NOLAN STREET, APT 1022 ELK GROVE, CA 95758 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $1K | — | $1K | 2.89% |
| TERESA K. DURRANT4 | 1256 FRED JACKSON WAY RICHMOND, CA 94801 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $939 | — | $939 | 2.50% |
| KATHLEEN R. GONZALES4 | 1269 LYNN AVE SAN JOSE, CA 95122 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $741 | — | $741 | 1.97% |
| MARIA GALICIA4 | 3601 NIGHTINGALE DR ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $689 | — | $689 | 1.84% |
| JOHN SCOTT WARD, LLC4 | 6216 DARTLE ST LAS VEGAS, NV 89130 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $101 | — | $101 | 0.27% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| RON FILICE ENTERPRISES INSURANCE BROKER | Insurance agents and brokers Service code 22 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | $134K |
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 | 1,469 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 17 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,486 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 1,296 | $16.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 2,008 | $89K |
| Vision(7 contracts) | VISION SERVICE PLAN | 629 | $203K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,457 | $480K |
| Long-term disability | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,457 | $480K |
| Other(3 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 1,457 | $600K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,008 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.