| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC. | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $118K | $0 | $118K | 3.44% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | $38K | $0 | $38K | 1.12% |
| FILICE INSURANCE AGENCY3 | 738 NORTH FIRST STREET SAN JOSE, CA 95112 | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | -$120 | $8K | $8K | 0.23% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC. | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.36% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | ANTHEM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.18% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC. | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM LIFE INSURANCE COMPANY | $2K | $0 | $2K | 2.80% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | ANTHEM LIFE INSURANCE COMPANY | $1K | $0 | $1K | 1.40% |
| FILICE INSURANCE AGENCY3 Filed as: FILICE INSURANCE SERVICES, LLC. | 900 EAST HAMILTON AVENUE SUITE 500 CAMPBELL, CA 95008 | ANTHEM LIFE INSURANCE COMPANY | $475 | $0 | $475 | 2.36% |
| ACRISURE LLC3 Filed as: ACRISURE PARTNERS WEST COAST INS | 100 OTTAWA AVENUE SW GRAND RAPIDS, MI 49503 | ANTHEM LIFE INSURANCE COMPANY | $238 | $0 | $238 | 1.18% |
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 | 360 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 361 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 540 | $3.4M |
| Dental | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 540 | $3.4M |
| Vision | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 540 | $3.4M |
| Life insurance(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 354 | $73K |
| Short-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 91 | $20K |
| Long-term disability(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 382 | $88K |
| Prescription drug | ANTHEM BLUE CROSS LIFE AND HEALTH INSURANCE COMPANY | 540 | $3.4M |
| Other(2 contracts) | ANTHEM LIFE INSURANCE COMPANY | 354 | $73K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 540 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.