| 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 | BLUE CROSS OF CALIFORNIA | $55K | $10K | $65K | 2.44% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $58K | $3 | $58K | 3.39% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $33K | $1 | $33K | 3.38% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | — | $2K | 3.19% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $80K | — | $80K | 116.88% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | SIMNSA HEALTH PLAN | $4K | — | $4K | 7.00% |
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 | 700 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 14 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 714 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(5 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 680 | $5.5M |
| Dental(3 contracts, 3 carriers) | BLUE CROSS OF CALIFORNIA | 700 | $2.8M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 700 | $69K |
| Life insurance | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 700 | $69K |
| Prescription drug(5 contracts, 4 carriers) | BLUE CROSS OF CALIFORNIA | 680 | $5.5M |
| Other | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 700 | $69K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 700 | — |
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."
No prospect flags tripped on this filing.