| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N FIRST ST., SUITE 202 SAN JOSE, CA 95112 | BLUE CROSS OF CALIFORNIA | $329K | $191K | $520K | 5.92% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | — | $1K | $1K | 0.07% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $22K | — | $22K | 3.47% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $3K | — | $3K | 2.30% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | CHUBB COMBINED INSURANCE | $63K | — | $63K | 55.22% |
| EXPLAIN MY BENEFITS LLC3 Filed as: EXPLAIN MY BENEFITS, LLC | — | CHUBB COMBINED INSURANCE | $306 | — | $306 | 0.27% |
| GALLAGHER BENEFIT SERVICES, INC.3 | — | CHUBB COMBINED INSURANCE | $170 | — | $170 | 0.15% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| PRUDENTIAL INS. CO. AMERICA EIN 22-1211670 THIRD PARTY ADMIN | Claims processing; Contract Administrator Service code 12 | — | $17K |
| COMPSYCH EIN 35-3739783 THIRD PARTY ADMIN | Claims processing; Contract Administrator Service code 12 | — | $16K |
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 | 942 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 5 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 947 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 795 | $10.4M |
| Dental | BLUE CROSS OF CALIFORNIA | 795 | $8.8M |
| Vision | VISION SERVICE PLAN | 754 | $139K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 942 | $620K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 942 | $620K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 942 | $620K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC. | 178 | $1.6M |
| Other(2 contracts, 2 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 942 | $733K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 942 | — |
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.
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.