| 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 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $9K | $9K | 2.15% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $4K | $4K | 2.35% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH CUSTOM BEN | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 1.67% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SRVCS NATIONAL, INC | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $548 | — | $548 | 0.91% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AN AON COMP | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $4 | $439 | $443 | 0.74% |
| 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 | $283 | — | $283 | 0.47% |
| THE AGURS GROUP INC.4 Filed as: THE AGURS GROUP, INC | 5213 TAMANAR DRIVE LAS VEGAS, NV 89130 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $6K | — | $6K | 13.58% |
| GRACE S. COTA4 | 7342 PATERO CIRCLE SACRAMENTO, CA 95823 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $692 | — | $692 | 1.63% |
| KATHLEEN R. GONZALES4 | 5213 TAMANAR DR LAS VEGAS, NV 89130 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $453 | — | $453 | 1.07% |
| JEREMY A. GOMEZ4 Filed as: JEREMY A GOMEZ | 43805 MONTEREY AVE, APT 24 PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $329 | — | $329 | 0.78% |
| LINDA J. CASH4 Filed as: LINDA J CASH | 3430 TULLY RD, SUITE 20-426 MODESTO, CA 95350 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $329 | — | $329 | 0.78% |
| TERESA K. DURRANT4 | 1256 FRED JACKSON WAY RICHMOND, CA 94801 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $186 | — | $186 | 0.44% |
| MARIA GALICIA4 | 3601 NIGHTINGALE DR ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $168 | — | $168 | 0.40% |
| 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 |
| ANTHEM BLUE CROSS EIN 95-3760980 NETWORK PROVIDER | Claims processing; Contract Administrator Service code 12 | — | $57K |
| CAPITOL ADMINISTRATORS EIN 68-0116790 THIRD PARTY ADMIN | Contract Administrator; Claims processing Service code 12 | — | $57K |
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 | 1,520 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,534 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,377 | $12.0M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 2,300 | $101K |
| Vision | VISION SERVICE PLAN | 1,349 | $220K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,518 | $429K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,518 | $429K |
| Prescription drug | SUTTER HEALTH PLAN | 821 | $4.3M |
| Stop-loss / reinsurancereinsurance | GERBER LIFE INSURANCE COMPANY | 242 | $652K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,518 | $704K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,300 | — |
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.