| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES 3155 OLSEN DR, STE 400 SAN JOSE, CA 95117 | UNITEDHEALTHCARE INSURANCE COMPANY | $40K | — | $40K | 4.46% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INS SERV, INC. | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | UNITEDHEALTHCARE INSURANCE COMPANY | — | $19K | $19K | 2.15% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | — | $9K | 1.46% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $8K | — | $8K | 1.38% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SVS LLC | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.61% |
| ACRISURE LLC3 Filed as: ACRISURE WEST COAST | INSURANCE SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 14.71% |
| ASSUREDPARTNERS3 Filed as: EMERSON ROGERS, LLC | 669 RIVER DR CENTER II, STE 30 ELMWOOD PARK, NJ 07407 | VISION SERVICE PLAN | $584 | — | $584 | 6.00% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SVS LLC | 3155 OLSEN DR STE 400 SAN JOSE, CA 95117 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $713 | — | $713 | 10.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $263 | $263 | 3.69% |
| MASOLI LEGACY LLC4 | 4319 BLENHEIM WAY CONCORD, CA 94521 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $128 | — | $128 | 18.77% |
| MOSS/PHILLIPS ASSOCIATES4 | 1232 HI POINT ST LOS ANGELES, CA 90035 | PRE-PAID LEGAL SERVICES INC DBA LEGALSHIELD | $25 | — | $25 | 3.67% |
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 | 117 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 117 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $1.5M |
| Dental | UNITEDHEALTHCARE INSURANCE COMPANY | 151 | $897K |
| Vision | VISION SERVICE PLAN | 73 | $10K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $7K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 117 | $33K |
| Other(3 contracts, 3 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 117 | $40K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.