| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $49K | — | $49K | 2.32% |
| EDGEWOOD PARTNERS INSURANCE CENTER3 | 425 CALIFORNIA STREET SAN FRANCISCO, CA 94104 | KAISER FOUNDATION HEALTH PLAN INC. | -$83 | — | -$83 | -0.00% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $686 | — | $686 | 2.16% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $1K | $3K | 15.17% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | EYEMED VISION CARE | $2K | — | $2K | 11.48% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $719 | $361 | $1K | 15.03% |
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 | 268 | 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) | 268 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 301 | $2.2M |
| Vision | EYEMED VISION CARE | 228 | $17K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $7K |
| Short-term disability | AMERICAN FIDELITY ASSURANCE COMPANY | 7 | $1K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 266 | $20K |
| Prescription drug(2 contracts) | KAISER FOUNDATION HEALTH PLAN INC. | 301 | $2.2M |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 268 | $28K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.