| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $9K | — | $9K | 2.21% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | 3475 E. FOOTHILL BLVD. SUITE 100 PASADENA, CA 91107 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $4K | — | $4K | 1.02% |
| GIS BENEFITS INC3 Filed as: GIS NORTHERN CALIFORNIA | 315 MONTGOMERY STREET SUITE 900 SAN FRANCISCO, CA 94104 | METLIFE LEGAL PLANS | $2K | — | $2K | 13.55% |
| GIS BENEFITS INC3 Filed as: GIS NATIONAL | 9500 KOGER AVENUE SUITE 200 ST. PETERSBURG, FL 33702 | METLIFE LEGAL PLANS | $1K | — | $1K | 8.34% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISE, INC. | 900 E. HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | METLIFE LEGAL PLANS | $1K | — | $1K | 6.19% |
| BOON CHAPMAN BENEFIT ADMINISTRATORS3 Filed as: BOON-CHAPMAN BENEFIT ADMINISTRATORS | P.O. BOX 9201 BLDG. I, SUITE 100 AUSTIN, TX 78766 | METLIFE LEGAL PLANS | — | $902 | $902 | 5.08% |
| HUB INTERNATIONAL MIDWEST LIMITED3 Filed as: BOLTON & COMPANY | P.O. BOX 6030 PASADENA, CA 911026030 | METLIFE LEGAL PLANS | $677 | — | $677 | 3.81% |
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 | 498 | 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) | 498 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 502 | $3.0M |
| Dental | DELTA DENTAL OF CALIFORNIA | 481 | $660K |
| Vision | VISION SERVICE PLAN | 480 | $71K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN, INC | 502 | $3.0M |
| Other | METLIFE LEGAL PLANS | 71 | $18K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 502 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.