| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | P.O. BOX 101162 PASADENA, CA 91189 | KAISER FOUNDATION HEALTH PLAN INC. | $31K | — | $31K | 4.11% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | P.O. BOX 101162 PASADENA, CA 91189 | METROPOLITAN LIFE INSURANCE COMPANY | $9K | $2K | $10K | 9.91% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | METROPOLITAN LIFE INSURANCE COMPANY | $831 | — | $831 | 0.80% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | P.O. BOX 101162 PASADENA, CA 91189 | VISION SERVICE PLAN | $922 | — | $922 | 5.65% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $148 | — | $148 | 0.91% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | P.O. BOX 101162 PASADENA, CA 91189 | SAFEGUARD HEALTH PLANS, INC. | $1K | $231 | $1K | 8.91% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES INC. | 738 N. 1ST STREET, SUITE 202 SAN JOSE, CA 95112 | SAFEGUARD HEALTH PLANS, INC. | $93 | — | $93 | 0.66% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS INSURANCE SERVICES OF CA | P.O. BOX 101162 PASADENA, CA 91189 | MANAGED HEALTH NETWORK | $354 | — | $354 | 5.00% |
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 | 186 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 190 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 172 | $749K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 236 | $117K |
| Vision | VISION SERVICE PLAN | 125 | $16K |
| Life insurance | METROPOLITAN LIFE INSURANCE COMPANY | 236 | $103K |
| Long-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 236 | $103K |
| Other(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 236 | $110K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 236 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.