| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 950080667 | UNITED HEALTHCARE INSURANCE COMPANY | $105K | — | $105K | 5.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 950080667 | KAISER FOUNDATION HEALTH PLANS INC | $96K | $3 | $96K | 4.86% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 950080667 | KAISER FOUNDATION HEALTH PLAN | $23K | — | $23K | 4.91% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 950080667 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | $19K | $33K | 8.03% |
| ENROLLMENT ALLIANCE LLC3 Filed as: ENROLLMENT ALLIANCE, LLC | 1724 5TH AVENUE TAMPA, CA 33605 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $16K | $16K | 3.84% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN OF HAWAII | $6K | — | $6K | 3.79% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARIN BENEFITS ADMINISTRATORS EIN 83-2706943 CLAIMS PROCESSING | Claims processing; Contract Administrator Service code 12 | 6366 COMMERCE BLV. #293 ROHNERT PARK, CA 94928 | $36K |
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 | 790 | 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) | 790 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 5 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 283 | $5.5M |
| Dental(3 contracts, 3 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $463K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 672 | $379K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 790 | $407K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 790 | $407K |
| Prescription drug(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLANS INC | 283 | $3.4M |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 790 | $407K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 790 | — |
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."
No prospect flags tripped on this filing.