| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | UNITED HEALTHCARE OF CALIFORNIA | $25K | $1K | $26K | 3.81% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET SAN FRANCISCO, CA 94105 | UNITED HEALTHCARE OF CALIFORNIA | $9K | — | $9K | 1.36% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN, INC. | $22K | — | $22K | 4.34% |
| WELLS FARGO INSURANCE SERVICES3 | 600 HIGHWAY 169 SOUTH, 12TH FLOOR SAINT LOUIS PARK, MN 55426 | KAISER FOUNDATION HEALTH PLAN, INC. | $4K | — | $4K | 0.84% |
| MICHAEL EDWARD CHAVEZ3 Filed as: MICHAEL CHAVEZ | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | — | $12K | 8.93% |
| WELLS FARGO INSURANCE SERVICES3 | 1018 WEST 9TH AVENUE KING OF PRUSSIA, PA 19406 | METROPOLITAN LIFE INSURANCE COMPANY | — | $472 | $472 | 0.35% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | METROPOLITAN LIFE INSURANCE COMPANY | — | $27 | $27 | 0.02% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 NORTH 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $2K | — | $2K | 7.40% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | VISION SERVICE PLAN | $618 | — | $618 | 2.18% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 NORTH FIRST STRETE, SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $351 | $2K | 11.47% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $580 | $38 | $618 | 3.33% |
| WELLS FARGO INSURANCE SERVICES3 | 45 FREMONT STREET, SUITE 800 SAN FRANCISCO, CA 94105 | LANDMARK HEALTHPLAN | $745 | — | $745 | 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 | 195 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 37 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 233 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE OF CALIFORNIA | 94 | $1.2M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 220 | $137K |
| Vision | VISION SERVICE PLAN | 184 | $28K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 189 | $26K |
| Prescription drug(2 contracts, 2 carriers) | UNITED HEALTHCARE OF CALIFORNIA | 94 | $1.2M |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 189 | $26K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 220 | — |
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.