| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 1150 MORAGA WAY MORAGA, CA 94556 | SUTTER HEALTH PLAN | $36K | — | $36K | 3.50% |
| WELLSON CHEUNG3 | 1668 EL CAMINO REAL SAN CARLOS, CA 94070 | SUTTER HEALTH PLAN | $16K | — | $16K | 1.50% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | CHINESE COMMUNITY HEALTH PLAN | $13K | — | $13K | 3.50% |
| WELCARE FINANCIAL GROUP3 | 1668 EL CAMINO REAL SAN CARLOS, CA 94070 | CHINESE COMMUNITY HEALTH PLAN | $5K | — | $5K | 1.50% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | GUARDIAN | $3K | — | $3K | 1.96% |
| WELLSON CHEUNG3 | 14 DOCKSIDE CIRCLE REDWOOD CITY, CA 94065 | GUARDIAN | $1K | — | $1K | 0.84% |
| PACIFIC ADVISORS LLC3 | 333 N. INDIAN HILL BLVD. CLAREMONT, CA 91711 | GUARDIAN | $49 | — | $49 | 0.03% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $4K | $66 | $4K | 3.54% |
| WELLSON CHEUNG3 | 1668 EL CAMINO REAL SAN CARLOS, CA 94070 | KAISER FOUNDATION HEALTH PLAN INC. | $2K | — | $2K | 1.49% |
| ROBERT C. PLACAK & ASSOC. INC.3 Filed as: ROBERT C. PLACAK | 790 MISSIN AVENUE SAN RAFAEL, CA 94901 | KAISER FOUNDATION HEALTH PLAN INC. | — | $2 | $2 | 0.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 1150 MORAGA WAY MORAGA, CA 94556 | CLAREMONT EAP | $244 | — | $244 | 4.76% |
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 | 179 | 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) | 183 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | SUTTER HEALTH PLAN | 141 | $1.5M |
| Dental | GUARDIAN | 179 | $153K |
| Prescription drug(3 contracts, 3 carriers) | SUTTER HEALTH PLAN | 141 | $1.5M |
| Other | CLAREMONT EAP | 199 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 199 | — |
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."
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.