| 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 | $124K | — | $124K | 4.37% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES LLC 3155 OLSEN DR, STE 100 SAN JOSE, CA 95117 | WESTERN HEALTH ADVANTAGE | $19K | — | $19K | 1.81% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | WESTERN HEALTH ADVANTAGE | $16K | — | $16K | 1.46% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE CAMPBELL, CA 95008 | AETNA LIFE INSURANCE CO. | $18K | $13K | $31K | 6.95% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 3155 OLSEN DR SAN JOSE, CA 95117 | AETNA LIFE INSURANCE CO. | $26K | — | $26K | 5.80% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | SUTTER HEALTH PLAN | $18K | — | $18K | 4.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $3K | $11K | 11.37% |
| FMLASOURCE INC5 | 455 N CITYFRONT PLZ DR 13TH FLOOR CHICAGO, IL 60611 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $10K | $10K | 9.66% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | — | $2K | 1.56% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES | 738 N 1ST STREET SAN JOSE, CA 95112 | WESTERN HEALTH ADVANTAGE | $76K | — | $76K | 84.18% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICE LLC 3155 OLSEN DR, STE 100 SAN JOSE, CA 95117 | WESTERN HEALTH ADVANTAGE | $14K | — | $14K | 15.82% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $7K | $3K | $10K | 12.51% |
| BENERATION LLC5 | 2124 RACE ST GROUND FLOOR PHILADELPHIA, PA 19103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.22% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.54% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $3K | $9K | 12.41% |
| BENERATION LLC5 | 2124 RACE ST GROUND FLOOR PHILADELPHIA, PA 19103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 4.44% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | — | $1K | 1.55% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 12.41% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $636 | — | $636 | 1.55% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $2K | $5K | 12.76% |
| BENERATION LLC5 | 2124 RACE ST GROUND FLOOR PHILADELPHIA, PA 19103 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 9.00% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $602 | — | $602 | 1.56% |
| FILICE INSURANCE AGENCY3 | 738 NORTH 1ST STREET SAN JOSE, CA 95112 | HEALTHIESTYOU C/O TELADOC HEALTH INC | $5K | — | $5K | 15.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $1K | $4K | 12.73% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $492 | — | $492 | 1.47% |
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 | 600 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 600 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 385 | $4.4M |
| Dental | AETNA LIFE INSURANCE CO. | 902 | $453K |
| Vision | AETNA LIFE INSURANCE CO. | 902 | $453K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 606 | $121K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 108 | $74K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 584 | $101K |
| Prescription drug(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 385 | $4.4M |
| Other(5 contracts, 2 carriers) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 606 | $231K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 902 | — |
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.