| 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. | $47K | $2 | $47K | 4.70% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | BLUE SHIELD OF CALIFORNIA | — | $40K | $40K | 4.17% |
| CENTERSTONE INSURANCE AND FINANCIAL3 | SERVICES 6200 CANOGA AVE, STE 300 WOODLAND HILLS, CA 91367 | BLUE SHIELD OF CALIFORNIA | $20K | — | $20K | 2.08% |
| BURNHAM BENEFITS INSURANCE SERVICES3 Filed as: BURHAM BENEFITS INSURANCE SER | 2211 MICHELSON DR STE 1200 IRVINE, CA 92612 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $11K | $2K | $13K | 10.79% |
| FILICE INSURANCE AGENCY3 | 738 N FIRST STREET SUITE 202 SAN JOSE, CA 95112 | EYEMED VISION CARE | $2K | — | $2K | 9.91% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | DELTA DENTAL OF CALIFORNIA | $197 | — | $197 | 2.35% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | 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 | 226 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 230 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 180 | $1.9M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 278 | $8K |
| Vision | EYEMED VISION CARE | 291 | $21K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $117K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $117K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $117K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 82 | $949K |
| Other | UNUM LIFE INSURANCE COMPANY OF AMERICA | 226 | $117K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 291 | — |
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.