| 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. | $69K | — | $69K | 3.97% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.15% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $720 | $2K | 16.26% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $548 | — | $548 | 3.99% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $675 | $299 | $974 | 15.94% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $242 | — | $242 | 3.96% |
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 | 180 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 243 | $1.7M |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 99 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $6K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 180 | $14K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 243 | $1.7M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 178 | $6K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 243 | — |
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."
Total premium grew more than 20% over prior year. Renewal pain — prime candidate for re-shopping the carriers.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.