| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN, INC. | $41K | — | $41K | 5.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 945561113 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $907 | $3K | 4.42% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 3155 OLSEN DRIVE SAN JOSE, CA 951171661 | METROPOLITAN LIFE INSURANCE COMPANY | $513 | $713 | $1K | 1.58% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E. HAMILTON AVE.#500 CAMPBELL, CA 95008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $5K | $857 | $6K | 12.20% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $876 | — | $876 | 5.91% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE AGENCY, INC. | 738 N. FIRST ST., SUITE 202 SAN JOSE, CA 95112 | VISION SERVICE PLAN | $128 | — | $128 | 0.86% |
| RYAN BEHM3 Filed as: RYAN PRESTON | 1150 MORAGA WAY MORAGA, CA 945561113 | LANDMARK HEALTH PLAN | $1K | — | $1K | 10.00% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 1150 MORAGA WAY MORAGA, CA 945561113 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $382 | $96 | $478 | 8.29% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS. | 3155 OLSEN DRIVE SAN JOSE, CA 95117 | SAFEGUARD HEALTH PLANS, INC. A CALIFORNIA CORPORATION | $201 | $53 | $254 | 4.41% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| MARIN BENEFITS ADMINISTRATORS EIN 83-2706943 BROKER | Contract Administrator; Other services; Plan Administrator; Claims processing Service code 12 | 6366 COMMERCE BLVD. #293 ROHNERT PARK, CA 94928 | $33K |
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 | 157 | 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) | 157 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN, INC. | 157 | $817K |
| Dental(2 contracts, 2 carriers) | METROPOLITAN LIFE INSURANCE COMPANY | 156 | $83K |
| Vision | VISION SERVICE PLAN | 84 | $15K |
| Life insurance | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $47K |
| Long-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $47K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN, INC. | 157 | $817K |
| Other(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 124 | $57K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 157 | — |
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.