| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 3155 OLSEN DRIVE 4TH FLOOR SAN JOSE, CA 95117 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $18K | — | $18K | 7.66% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST | 3155 OLSEN DRIVE SUITE 400 SAN JOSE, CA 95117 | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | $6K | — | $6K | 2.30% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $3K | $6K | 14.18% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 13.23% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $2K | $5K | 14.17% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | SERVICES LLC 100 OTTAWA AVE SW GRAND RAPIDS, MI 49503 | VISION SERVICE PLAN | $2K | — | $2K | 8.36% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E. HAMILTON AVE CAMPBELL, CA 95008 | VISION SERVICE PLAN | $808 | — | $808 | 2.86% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $1K | $2K | 14.18% |
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 | 88 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 4 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 92 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 99 | $240K |
| Vision | VISION SERVICE PLAN | 98 | $28K |
| Life insurance(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $67K |
| Short-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $17K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $41K |
| Other(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 92 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 99 | — |
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.