| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $23K | — | $23K | 4.17% |
| ACRISURE LLC3 Filed as: ACRISURE WEST INSURANCE SERVICES LL | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $19K | — | $19K | 3.39% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SVCS | 32110 AGOURA RD WESTLAKE VILLAGE, CA 91361 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $11K | $11K | 2.05% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | — | $2K | $2K | 0.33% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | KAISER FOUNDATION HEALTH PLAN INC | $25K | — | $25K | 5.05% |
| ACRISURE LLC3 Filed as: ACRISURE WEST | 3155 OLSEN DRIVE, STE 400 SAN JOSE, CA 95114 | CYPRESS DENTAL ADMINISTRATORS | $12K | — | $12K | 9.99% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 900 E HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM LIFE INSURANCE COMPANY | $854 | — | $854 | 3.53% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COASTINSURAN | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | ANTHEM LIFE INSURANCE COMPANY | $711 | — | $711 | 2.94% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES LLC | 900 E HAMILTON AVE STE 500 CAMPBELL, CA 95008 | ANTHEM LIFE INSURANCE COMPANY | $178 | — | $178 | 9.91% |
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 | 255 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 256 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 250 | $1.4M |
| Dental | CYPRESS DENTAL ADMINISTRATORS | 175 | $119K |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 250 | $555K |
| Life insurance(3 contracts, 2 carriers) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 250 | $581K |
| Prescription drug | KAISER FOUNDATION HEALTH PLAN INC | 109 | $504K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 250 | — |
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.