| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVE, SUITE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC | $141K | — | $141K | 4.10% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY MORAGA | 1150 MORAGA WAY MORAGA, CA 94556 | SUTTER HEALTH PLAN | $21K | — | $21K | 3.31% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 3155 OLSEN DRIVE, STE.400 SAN JOSE, CA 95117 | SUTTER HEALTH PLAN | $11K | — | $11K | 1.69% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 94556 | HOMETOWN HEALTH | $25K | — | $25K | 5.50% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, LLC | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | GUARDIAN | $25K | $15K | $41K | 10.02% |
| ACRISURE LLC3 Filed as: ACRISURE WEST COAST INSURANCE SERV | 3155 OLSEN DRIVE, SUITE 400 SAN JOSE, CA 95117 | RELIASTAR LIFE INSURANCE COMPANY | $30K | — | $30K | 14.53% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 94556 | HOMETOWN HEALTH | $6K | — | $6K | 5.50% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FILICE INSURANCE SERVICES, LLC EIN 84-2930139 NONE | Insurance agents and brokers; Insurance brokerage commissions and fees Service code 22 | — | $66K |
| STAR MARKETING & ADMINISTRATION EIN 36-3403079 NONE | Claims processing; Other services; Plan Administrator Service code 12 | — | $51K |
| MULTIBENEFIT SERVICES WEST EIN 36-4104766 NONE | Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | — | $25K |
| CIGNA EIN 35-1846036 NONE | Claims processing; Other services Service code 12 | — | $6K |
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 | 357 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 357 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 350 | $4.7M |
| Dental | GUARDIAN | 316 | $407K |
| Vision | GUARDIAN | 316 | $407K |
| Life insurance | RELIASTAR LIFE INSURANCE COMPANY | 357 | $205K |
| Short-term disability | RELIASTAR LIFE INSURANCE COMPANY | 357 | $205K |
| Long-term disability | RELIASTAR LIFE INSURANCE COMPANY | 357 | $205K |
| Prescription drug(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 350 | $4.1M |
| Other(2 contracts, 2 carriers) | RELIASTAR LIFE INSURANCE COMPANY | 357 | $206K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 357 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.