| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | HEALTH NET | $49K | — | $49K | 5.00% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $10K | $10K | 18.39% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $5K | $1K | $7K | 12.33% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | GUARDIAN | — | $1K | $1K | 2.78% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $528 | $3K | 12.17% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $394 | $2K | 12.18% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $315 | $2K | 11.96% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 7.78% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 19.51% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $249 | $2K | 11.95% |
| PAYCOM PAYROLL LLC5 | 7501 W MEMORIAL ROAD OKLAHOMA CITY, OK 73142 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 13.51% |
| FILICE INSURANCE AGENCY3 | 900 E HAMILTON AVE. CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $925 | $198 | $1K | 12.14% |
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 | 320 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 322 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 303 | $3.9M |
| Dental | GUARDIAN | 283 | $49K |
| Vision | GUARDIAN | 283 | $49K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 320 | $72K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 41 | $13K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 320 | $24K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 303 | $3.9M |
| Other(4 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 320 | $98K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 320 | — |
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."
No prospect flags tripped on this filing.