| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | ANTHEM BLUE CROSS | $49K | — | $49K | 4.95% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS, INC | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | ANTHEM BLUE CROSS | — | $24K | $24K | 2.47% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN, INC | $22K | — | $22K | 4.46% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 2 PIERCE PLACE, 14TH FLOOR ITASCA, IL 601431203 | KAISER FOUNDATION HEALTH PLAN, INC | — | $552 | $552 | 0.11% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $2K | — | $2K | 9.84% |
| LAZIO CUMMINGS ENTERPRISES, INC3 | 111 WOODMERE ROAD, SUITE 290 FOLSOM, CA 95630 | PREMIER ACCESS INSURANCE COMPANY | $4K | — | $4K | 30.82% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | PREMIER ACCESS INSURANCE COMPANY | $4 | — | $4 | 0.03% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES, INC | 11060 WHITE ROCK ROAD, SUITE 160 RANCHO CORDOVA, CA 95670 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $369 | — | $369 | 5.37% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: DICKERSON EMPLOYEE BENEFITS, INC | 1918 RIVERSIDE DRIVE LOS ANGELES, CA 90039 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $344 | $344 | 5.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $318 | — | $318 | 4.63% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | LANDMARK HEALTHPLAN | $492 | — | $492 | 10.00% |
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 | 210 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 212 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | ANTHEM BLUE CROSS | 121 | $1.5M |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 408 | $13K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 401 | $25K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 199 | $7K |
| Other | LANDMARK HEALTHPLAN | 149 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 408 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.