| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | KAISER FOUNDATION HEALTH PLAN INC | $84K | — | $84K | 2.25% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA RD., STE. 100 AGOURA HILLS, CA 91301 | KAISER FOUNDATION HEALTH PLAN INC | $26K | — | $26K | 0.70% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC | $40 | — | $40 | 0.00% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 N. 1ST ST. STE. 202 SAN JOSE, CA 95112 | UNITEDHEALTHCARE INSURANCE COMPANY | $0 | $8K | $8K | 0.50% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | CHINESE COMMUNITY HEALTH PLAN | $29K | — | $29K | 2.74% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA RD. STE. 100 AGOURA HILLS, CA 91301 | CHINESE COMMUNITY HEALTH PLAN | $3K | — | $3K | 0.26% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | DELTA DENTAL OF CALIFORNIA | $16K | — | $16K | 2.53% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA RD. STE. 100 AGOURA HILLS, CA 91301 | DELTA DENTAL OF CALIFORNIA | $3K | — | $3K | 0.47% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $3K | $6K | 3.70% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $253 | $2K | 1.14% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | VISION SERVICE PLAN | $1K | — | $1K | 1.99% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA RD. STE. 100 AGOURA HILLS, CA 91910 | VISION SERVICE PLAN | $777 | — | $777 | 1.16% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES | 738 N. 1ST ST. STE. 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $519 | — | $519 | 0.77% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | LANDMARK HEALTH PLAN | $2K | — | $2K | 8.42% |
| HIXME INSURANCE SOLUTIONS, INC.3 | 27489 AGOURA RD. STE. 100 AGOURA HILLS, CA 91910 | LANDMARK HEALTH PLAN | $411 | — | $411 | 1.58% |
| HAYS COMPANIES, INC.3 Filed as: THE HAYS GROUP, INC. | 80 SO. 8TH ST. STE. 700 MINNEAPOLIS, MN 55402 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $270 | $2K | 15.03% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC | 738 NORTH FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $235 | $31 | $266 | 1.74% |
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 | 854 | 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) | 854 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 615 | $6.5M |
| Dental | DELTA DENTAL OF CALIFORNIA | 1,058 | $638K |
| Vision | VISION SERVICE PLAN | 475 | $67K |
| Life insurance(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 854 | $190K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 854 | $175K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 492 | $6.5M |
| Other(2 contracts) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 854 | $190K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,058 | — |
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.