| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $19K | $0 | $19K | 3.37% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 21820 BURBANK BOULEVARD, SUITE 310 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $9K | $0 | $9K | 1.61% |
| FILICE INSURANCE AGENCY3 | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $9K | $0 | $9K | 5.86% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: LIBERTY INTEGRA EMPLOYEE BENEFITS | 5955 DE SOTO AVENUE, SUITE 250 WOODLAND HILLS, CA 91367 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $4K | $0 | $4K | 2.43% |
| FILICE INSURANCE AGENCY3 | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $3K | $0 | $3K | 3.21% |
| LIBERTY COMPANY INSURANCE BROKERS3 Filed as: THE LIBERTY INSURANCE BROKERS | 21820 BURBANK BOULEVARD, SUITE 310 WOODLAND HILLS, CA 91367 | KAISER FOUNDATION HEALTH PLAN INC | $2K | $0 | $2K | 1.68% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS5 | PO BOX 9201 AUSTIN, TX 78766 | METROPOLITAN LIFE INSURANCE COMPANY | $15K | $4K | $19K | 24.02% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $1K | $1K | 1.83% |
| GIS BENEFITS INC3 Filed as: GIS BENEFITS, INC. | 422 WAUPONSEE STREET MORRIS, IL 60450 | METROPOLITAN LIFE INSURANCE COMPANY | $0 | $718 | $718 | 0.91% |
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 | 229 | 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) | 229 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 76 | $675K |
| Dental | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 175 | $157K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 229 | $78K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 229 | $78K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 229 | $78K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 229 | $78K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC | 76 | $675K |
| Other | METROPOLITAN LIFE INSURANCE COMPANY | 229 | $78K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 229 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.