| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | HEALTH NET | $30K | — | $30K | 2.77% |
| MACCORKLE INSURANCE SERVICES3 Filed as: MACCORKLE INSURANCE SERVICE | 577 AIRPORT BLVD STE 500 BURLINGAME, CA 94010 | HEALTH NET | $24K | — | $24K | 2.23% |
| MACCORKLE INSURANCE SERVICES3 | 577 AIRPORT BLVD STE 500 BURLINGAME, CA 940102023 | KAISER FOUNDATION HEALTH PLAN INC | $21K | — | $21K | 3.31% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $14K | — | $14K | 2.26% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSEE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.90% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 021101700 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 7.10% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 021101700 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 8.41% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 6.59% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $1K | — | $1K | 4.93% |
| MACCORKLE INSURANCE SERVICES3 | 577 AIRPORT BLVD STE 500 BURLINGAME, CA 940102023 | VISION SERVICE PLAN | $783 | — | $783 | 3.63% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.81% |
| RSC INSURANCE BROKERAGE INC3 | 160 FEDERAL ST BOSTON, MA 021101700 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 7.19% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 21ST FLOOR TWO PIERCE PLACE ITASCA, IL 60143 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $9 | $2K | 21.99% |
| MACCORKLE INSURANCE SERVICES3 Filed as: MACCORKLE INSURANCE SERVICE | — | DELTA DENTAL OF CALIFORNIA | $233 | — | $233 | 4.94% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | DELTA DENTAL OF CALIFORNIA | $198 | — | $198 | 4.20% |
| MACCORKLE INSURANCE SERVICES3 Filed as: MACCORKLE INSURANCE SERVICE | — | DELTA DENTAL OF CALIFORNIA | $6K | — | $6K | — |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | DELTA DENTAL OF CALIFORNIA | $5K | — | $5K | — |
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 | 159 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 159 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 122 | $1.7M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 140 | $5K |
| Vision | VISION SERVICE PLAN | 147 | $22K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $49K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 158 | $15K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 122 | $630K |
| Other(3 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 159 | $56K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 159 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.