| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN INC. | $41K | $2 | $41K | 5.16% |
| BENEFITS AMERICA INSURANCE SERVICES3 | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $68K | $5K | $73K | 9.98% |
| PIPES INSURANCE SERVICE LTD3 Filed as: PIPES INSURANCE | 442 WEST HIGH AVENUE NEW PHILADELPHIA, PA 44663 | AULTCARE INSURANCE COMPANY | $20K | — | $20K | 3.13% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $9K | $4K | $12K | 14.43% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | $5K | — | $5K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | $2K | $6K | 13.74% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE | 738 N. FIRST STREET, SUITE 202 SAN JOSE, CA 95112 | GUARDIAN | $12K | — | $12K | 30.80% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $901 | $3K | 14.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CIGNA HEALTH & LIFE INSURANCE EIN 59-1031071 CONTRACTOR ADMINISTRATOR | Float revenue; Claims processing; Non-monetary compensation; Direct payment from the plan; Named fiduciary; Participant communication; Other services; Contract Administrator Service code 12 | — | $57K |
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 | 579 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 585 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 408 | $2.2M |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 346 | $53K |
| Life insurance | UNITED OF OMAHA LIFE INSURANCE COMPANY | 576 | $21K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 174 | $86K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 579 | $44K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC. | 408 | $2.2M |
| Other(2 contracts, 2 carriers) | GUARDIAN | 576 | $60K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 579 | — |
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.