| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $127K | — | $127K | 3.69% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | HOMETOWN HEALTH | $22K | — | $22K | 5.62% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | SUTTER HEALTH PLAN | $15K | — | $15K | 4.98% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | RELIASTAR LIFE INSURANCE COMPANY | $24K | — | $24K | 14.52% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $5K | — | $5K | 10.05% |
| DIGITAL INSURANCE LLC3 Filed as: DIGITAL INSURANCE, INC. | 200 GALLERIA PKWY ATLANTA, GA 30339 | VISION SERVICE PLAN | $2 | — | $2 | 0.00% |
| FILICE INSURANCE AGENCY3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | HARTFORD LIFE AND ACCIDENT | $745 | — | $745 | 15.01% |
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 | 317 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 318 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 447 | $4.1M |
| Dental(2 contracts) | DELTA DENTAL OF CALIFORNIA | 216 | $347K |
| Vision | VISION SERVICE PLAN | 263 | $46K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 317 | $164K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 317 | $164K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 317 | $164K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 447 | $4.1M |
| Other(3 contracts, 3 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 317 | $175K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 447 | — |
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.