| 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. | $112K | — | $112K | 5.41% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $22K | — | $22K | 5.60% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 3155 OLSEN DR SAN JOSE, CA 95117 | METROPOLITAN LIFE INSURANCE COMPANY | — | $3K | $3K | 0.85% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N FIRST STREET SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN, INC. | $7K | — | $7K | 3.49% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | — | $13K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $7K | $7K | 5.88% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 5.67% |
| EA LEGACY LLC5 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 10.00% |
| 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 | $2K | 3.70% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.68% |
| EA LEGACY LLC5 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $6K | $6K | 15.00% |
| 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 | $2K | 5.64% |
| EA LEGACY LLC5 | 1724 E 5TH AVE TAMPA, FL 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $5K | $5K | 15.00% |
| 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 | $2K | 5.95% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES LLC 3155 OLSEN DR SAN JOSE, CA 95117 | SAFEGUARD HEALTH PLANS, INC., A CALIFORNIA CORPORATION | — | $252 | $252 | 0.87% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE SUITE 500 CAMPBELL, CA 95008 | METLIFE LEGAL PLANS | $1K | $1K | $2K | 15.80% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 1150 MORAGA WAY MORAGA, CA 94556 | METLIFE LEGAL PLANS | $204 | — | $204 | 1.33% |
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 | 685 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 690 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 292 | $3.6M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $451K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 757 | $366K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 684 | $176K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 147 | $40K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 685 | $105K |
| Prescription drug(4 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 292 | $3.6M |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 684 | $290K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 757 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.