| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $58K | — | $58K | 5.67% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | — | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $16K | — | $16K | 1.60% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $28K | — | $28K | 5.39% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $41K | — | $41K | 17.43% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $28 | $28 | 0.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 15.00% |
| LONG TERM CARE SOLUTIONS, INC.3 | 14715 NE 9TH ST. STE 200 REDMOND, WA 98052 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $415 | — | $415 | 1.23% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $3K | — | $3K | 9.08% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | VISION SERVICE PLAN | $255 | — | $255 | 0.92% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH AND LIFE INS COMPANY EIN 59-1031071 CONTRACT ADMINISTRATOR | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Participant communication; Other services; Contract Administrator Service code 12 | — | $28K |
| DIRECT DENTAL ADMINISTRATORS, LLC EIN 94-3270798 CONTRACT ADMINISTRATOR | Contract Administrator Service code 13 | 7510 SHORELINE DRIVE STOCKTON, CA 95219 | $22K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 71 | $1.5M |
| Vision | VISION SERVICE PLAN | 107 | $28K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 114 | $237K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 114 | $237K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 114 | $237K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 71 | $526K |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 114 | $271K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 114 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Final-filing indicator set. Plan is winding down; don't waste sales effort here.