| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95125 | BLUE SHIELD OF CALIFORNIA | $137 | $200K | $200K | 3.96% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | BLUE SHIELD OF CALIFORNIA | $37 | $69K | $69K | 1.36% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N FIRST ST, #200 SAN JOSE, CA 95112 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $24K | $2K | $27K | 10.85% |
| CASSIDY O'HARA3 Filed as: CASSIDY EVAN OHARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $4K | $4K | 3.74% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $13K | — | $13K | 25.00% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $3K | $3K | 5.47% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 1123 CHERRY AVE SAN JOSE, CA 951253718 | METROPOLITAN LIFE INSURANCE COMPANY | $5K | — | $5K | 9.86% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $4K | — | $4K | 10.00% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $1K | $1K | 3.55% |
| FILICE INSURANCE AGENCY3 Filed as: RON FILICE ENTERPRISES, INC. | 738 N 1ST ST SAN JOSE, CA 95112 | CONTINENTAL AMERICAN INSURANCE COMPANY | $1K | — | $1K | 4.19% |
| CYNTHIA LUQUIN3 | 1615 WILSON AVENUE UPLAND, CA 91784 | CONTINENTAL AMERICAN INSURANCE COMPANY | $921 | — | $921 | 3.70% |
| PATRICIA GAIL LEES3 Filed as: PATRICIA G LEES | 1124 CHURCHS CT BURBANK, CA 91501 | CONTINENTAL AMERICAN INSURANCE COMPANY | $298 | — | $298 | 1.20% |
| FRANCOISE YVONNE KORENBERG3 Filed as: FRANCOISE Y KORENBERG | 6055 E WASHINGTON BLVD, SUITE 460 COMMERCE, CA 90040 | CONTINENTAL AMERICAN INSURANCE COMPANY | $93 | — | $93 | 0.37% |
| DAVID REESOR3 | 1615 WILSON AVENUE UPLAND, CA 91784 | CONTINENTAL AMERICAN INSURANCE COMPANY | $85 | — | $85 | 0.34% |
| DAVID REESOR3 | 1615 WILSON AVENUE UPLAND, CA 91784 | CONTINENTAL AMERICAN INSURANCE COMPANY | $81 | — | $81 | 0.33% |
| DAVID M COUGHLIN3 | 3311 S RAINBOW BLVD SUITE 102 LAS VEGAS, NV 89146 | CONTINENTAL AMERICAN INSURANCE COMPANY | $67 | — | $67 | 0.27% |
| SHEM J BOSTICK3 Filed as: SHEM J. BOSTICK | 1325 MT. HERMON RD #73B SALISBURY, MD 21804 | CONTINENTAL AMERICAN INSURANCE COMPANY | $22 | — | $22 | 0.09% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $713 | — | $713 | 6.64% |
| CASSIDY O'HARA3 Filed as: CASSIDY E. O'HARA | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | — | $410 | $410 | 3.82% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC | 738 N 1ST ST SAN JOSE, CA 95112 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $362 | — | $362 | 3.37% |
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 | 279 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 6 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 285 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE SHIELD OF CALIFORNIA | 318 | $5.1M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY | 293 | $244K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 750 | $48K |
| Life insurance(2 contracts, 2 carriers) | CONTINENTAL AMERICAN INSURANCE COMPANY | 342 | $36K |
| Long-term disability | UNITED OF OMAHA LIFE INSURANCE COMPANY | 340 | $100K |
| Prescription drug | BLUE SHIELD OF CALIFORNIA | 318 | $5.1M |
| Other(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 342 | $99K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 750 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.