| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN, INC. | $35K | $2 | $35K | 5.04% |
| PATRIOT GROWTH INSURANCE SERVICES3 Filed as: PATRIOT GROWTH INSURANCE SERVICES, | 8 CREEKLEDGE CT. DANVILLE, CA 945062000 | KAISER FOUNDATION HEALTH PLAN, INC. | -$82 | — | -$82 | -0.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 945561113 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.46% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 945561113 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | — | $5K | 10.55% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $875 | — | $875 | 6.45% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 945561113 | LANDMARK HEALTH PLAN | $2K | — | $2K | 30.01% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 945561113 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $641 | — | $641 | 10.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARIN BENEFITS ADMINISTRATORS EIN 83-2706943 NONE | Insurance agents and brokers; Insurance services; Other services; Plan Administrator; Claims processing; Insurance brokerage commissions and fees; Contract Administrator Service code 12 | 6366 COMMERCE BLVD #293 ROHNERT PARK, CA 94928 | $55K |
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 | 162 | 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) | 162 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 162 | $686K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 154 | $67K |
| Vision | VISION SERVICE PLAN | 85 | $14K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $50K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $50K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 162 | $686K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 128 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 162 | — |
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.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.