| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $10K | $10K | 2.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 2.00% |
| ANTHONY AGURS GROUP, INC4 | 5721 FRENCH LACE CT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $4K | — | $4K | 10.43% |
| GRACE S. COTA4 | 7342 PATERO CIRCLE SACRAMENTO, CA 95823 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $247 | — | $247 | 0.68% |
| LINDA J. CASH4 | 3430 TULLY RD, SUITE 20-426 MODESTO, CA 95350 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $159 | — | $159 | 0.44% |
| KATHLEEN R. GONZALES4 | 5721 FRENCH LACE CT NORTH LAS VEGAS, NV 89081 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $140 | — | $140 | 0.39% |
| MARIA GALICIA4 | 3601 NIGHTINGALE DR ANTIOCH, CA 94509 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $68 | — | $68 | 0.19% |
| TERESA K. DURRANT4 | 1256 FRED JACKSON WAY RICHMOND, CA 94801 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $65 | — | $65 | 0.18% |
| CHRISTINE WALKER4 | 591 DREW VIEW LN SAN DIEGO, CA 92113 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $63 | — | $63 | 0.17% |
| JEREMY A. GOMEZ4 | 43805 MONTEREY AVE, APT 24 PALM DESERT, CA 92260 | PRE-PAID LEGAL SERVICES, INC DBA LEGALSHIELD | $36 | — | $36 | 0.10% |
| PANTALONE, JO, ANN3 Filed as: PANTALONE, LOUIS, JOSEPH CUSTOM BEN | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $124 | — | $124 | 1.54% |
| USI INSURANCE SERVICES LLC3 | 201 MISSION STREET, SUITE 1100 SAN FRANCISCO, CA 94105 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $53 | — | $53 | 0.66% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $26 | — | $26 | 0.32% |
| AON CONSULTING INC3 Filed as: CUSTOM BENEFIT PROGRAMS AN AON COMP | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1 | — | $1 | 0.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FILICE INSURANCE SERVICES, LLC INSURANCE BROKER | Insurance agents and brokers Service code 22 | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | $134K |
| ANTHEM EIN 84-0747736 NETWORK PROVIDER | Other services; Claims processing; Contract Administrator Service code 12 | — | $79K |
| LUCENT HEALTH EIN 39-1997579 THIRD PARTY ADMIN | Contract Administrator; Claims processing Service code 12 | — | $78K |
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 | 1,596 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 38 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,634 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 1,404 | $14.1M |
| Dental(6 contracts) | DELTA DENTAL OF CALIFORNIA | 1,908 | $90K |
| Vision | VISION SERVICE PLAN | 1,334 | $227K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,635 | $513K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,635 | $513K |
| Prescription drug | SUTTER HEALTH PLAN | 891 | $5.2M |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE OF CALIFORNIA | 290 | $679K |
| Other(4 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 1,635 | $731K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,908 | — |
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 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.