| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $25K | — | $25K | 3.25% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY - MORAGA | 1150 MORAGA WAY MORAGA, CA 94556 | SUTTER HEALTH PLAN | $9K | — | $9K | 1.99% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | SUTTER HEALTH PLAN | $5K | — | $5K | 1.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILIVE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $3K | $7K | 15.02% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $5K | 15.03% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | — | $2K | 9.13% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E. HAMILTON AVE CAMPBELL, CA 95008 | VISION SERVICE PLAN | $164 | — | $164 | 0.86% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $864 | $410 | $1K | 14.74% |
| ACRISURE LLC3 Filed as: ACRISURE OF CALIFORNIA, LLC | 1150 MORAGA WAY MORAGA, CA 94556 | CONCERN | $332 | — | $332 | 5.01% |
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 | 116 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 103 | $1.2M |
| Vision | VISION SERVICE PLAN | 97 | $19K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $58K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 115 | $36K |
| Prescription drug | SUTTER HEALTH PLAN | 54 | $451K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 118 | $65K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 118 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.