| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FOLETTI INSURANCE SERVICES3 | 520 MARIA DRIVE PETALUMA, CA 94954 | HEALTH NET | $39K | — | $39K | 4.53% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | HEALTH NET | $4K | — | $4K | 0.46% |
| FOLETTI INSURANCE SERVICES3 | 520 MARIA DRIVE PETALUMA, CA 94954 | KAISER FOUNDATION HEALTH PLAN INC. | $35K | — | $35K | 4.56% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $3K | $1 | $3K | 0.41% |
| FOLETTI INSURANCE SERVICES3 | 520 MARIA DRIVE PETALUMA, CA 94954 | GUARDIAN | $19K | — | $19K | 20.12% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | GUARDIAN | $1K | — | $1K | 1.35% |
| FOLETTI INSURANCE SERVICES3 | 520 MARIA DRIVE PETALUMA, CA 94954 | VISION SERVICE PLAN | $894 | — | $894 | 5.83% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $46 | — | $46 | 0.30% |
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 | 166 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 170 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH NET | 89 | $1.6M |
| Dental | GUARDIAN | 166 | $96K |
| Vision | VISION SERVICE PLAN | 162 | $15K |
| Life insurance | GUARDIAN | 166 | $96K |
| Short-term disability | GUARDIAN | 166 | $96K |
| Long-term disability | GUARDIAN | 166 | $96K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 89 | $763K |
| Other | GUARDIAN | 166 | $96K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 166 | — |
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.