| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $92K | — | $92K | 6.36% |
| CENTERSTONE INSURANCE AND FINANCIAL3 Filed as: CENTERSTONE INS & FINANCIAL SRVCS | 12404 PARK CENTRAL DRIVE, STE 400S DALLAS, TX 75251 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $29K | $29K | 2.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $48K | $509 | $48K | 5.43% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 14.96% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $2K | — | $2K | 9.99% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $804 | $4K | 24.39% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $584 | $2K | 15.12% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE ADVANTAGE GROUP NONE | Contract Administrator; Claims processing Service code 12 | 43471 RIDGE PARK DRIVE, SUITE B TEMECULA, CA 92590 | $1K |
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 | 143 | 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) | 143 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 311 | $2.5M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 311 | $1.4M |
| Vision | VISION SERVICE PLAN | 93 | $19K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $11K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 143 | $37K |
| Other(2 contracts, 2 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 143 | $30K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 311 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.