| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN, INC | $26K | $2 | $26K | 4.56% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 9.98% |
| LAZIO CUMMINGS ENTERPRISES, INC3 | 111 WOODMERE ROAD, SUITE 290 FOLSOM, CA 95630 | PREMIER ACCESS INSURANCE COMPANY | $5K | — | $5K | 31.22% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $853 | $327 | $1K | 18.06% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | LANDMARK HEALTHPLAN | $538 | — | $538 | 10.01% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| BLUE SHIELD EIN 95-2156846 NETWORK PROVIDER | Insurance services Service code 23 | — | $35K |
| CAPITOL ADMINISTRATORS EIN 68-0116790 THIRD PARTY ADMINISTRATO | Plan Administrator Service code 14 | — | $33K |
| FILICE INSURANCE AGENCY EIN 77-0261203 INSURANCE BROKER | Insurance agents and brokers Service code 22 | — | $21K |
| PHIA GROUP EIN 46-1439866 FIDUCIARY&APPEALS REVIEW | Other services Service code 49 | — | $2K |
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 | 226 | 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) | 226 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC | 117 | $572K |
| Dental | PREMIER ACCESS INSURANCE COMPANY | 420 | $15K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 407 | $28K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 204 | $7K |
| Stop-loss / reinsurancereinsurance(2 contracts) | WESTPORT INSURANCE CORPORATION | 123 | $334K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 204 | $12K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 420 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.