| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $10K | — | $10K | 1.37% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INSURA | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | KAISER FOUNDATION HEALTH PLAN, INC. | $9K | — | $9K | 1.33% |
| ABD INS. AND FINANCIAL SVCS., INC.3 Filed as: ABD INSURANCE AND FINANCIAL | SERVICES INC 777 MARINERS ISLAND BLVD, STE 250 SAN MATEO, CA 94404 | KAISER FOUNDATION HEALTH PLAN, INC. | — | $88 | $88 | 0.01% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SERVICES LL | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS | $18K | — | $18K | 5.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $13K | — | $13K | 13.55% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 16.25% |
| ASSUREDPARTNERS3 Filed as: ASSURED PARTNERS OF OHIO LLC | 3900 KINROSS LAKES PKWY RICHFIELD, OH 44286 | STANDARD INSURANCE COMPANY | $94 | — | $94 | 0.66% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | STANDARD INSURANCE COMPANY | $2K | — | $2K | 17.31% |
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 | 113 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 114 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | KAISER FOUNDATION HEALTH PLAN, INC. | 86 | $1.1M |
| Dental | STANDARD INSURANCE COMPANY | 92 | $94K |
| Vision | STANDARD INSURANCE COMPANY | 85 | $11K |
| Life insurance | STANDARD INSURANCE COMPANY | 113 | $14K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 113 | — |
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.