| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $41K | — | $41K | 4.64% |
| CBIZ BENEFITS & INSURANCE SERVICES3 Filed as: CBIZ BENEFITS & INSURANCE SVCS | 160 W SANTA CLARA ST STE 450 SAN JOSE, CA 95113 | KAISER FOUNDATION HEALTH PLAN INC | -$4K | — | -$4K | -0.43% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 180 NOE ST SAN FRANCISCO, CA 94114 | SUTTER HEALTH PLAN | $18K | — | $18K | 5.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $3K | — | $3K | 12.21% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 738 N FIRST ST SUITE 202 SAN JOSE, CA 95112 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $1K | $1K | $2K | 19.36% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 11.88% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | $1K | — | $1K | 12.34% |
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 | 160 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 160 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 113 | $1.2M |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 149 | $13K |
| Life insurance | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $8K |
| Short-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 154 | $11K |
| Long-term disability | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $28K |
| Prescription drug | SUTTER HEALTH PLAN | 39 | $351K |
| Other | THE LINCOLN NATIONAL LIFE INSURANCE COMPANY | 160 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 160 | — |
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.