| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $17K | — | $17K | 4.63% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 S. EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $4K | — | $4K | 8.02% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $1K | — | $1K | 11.00% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $1K | $1K | 10.82% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $2K | $2K | 21.66% |
| FORREST T JONES AND COMPANY, INC5 Filed as: FORREST T. JONES | 3130 BROADWAY KANSAS CITY, MO 64111 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $1K | $1K | 10.83% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $510 | — | $510 | 5.00% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $245 | — | $245 | 11.01% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 1528 S. EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $241 | $241 | 10.83% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 NONE | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Other insurance fees and expenses; Contract Administrator Service code 12 | 1528 S. EL CAMINO REAL., SUITE 407 SAN MATEO, CA 94402 | $185K |
| ARMFIELD HARRISON & THOMAS LLC EIN 54-0654623 NONE | Contract Administrator; Participant communication Service code 13 | 20 SOUTH KING STREET LEESBURG, VA 20175 | $27K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Other services Service code 49 | 900 COTTAGE GROVE ROAD BLOOMFIELD, CT 06002 | $26K |
| FIDUCIARY PLAN MGMT SERVICES, INC. EIN 46-3922133 NONE | Accounting (including auditing); Trustee (directed) Service code 10 | 1 S. ALMADEN BLVD., SUITE 750 SAN JOSE, CA 95113 | $26K |
| UNITED WORKERS WELLNESS EIN 87-2575833 NONE | Other services Service code 49 | — | $5K |
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 | 179 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 179 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 33 | $53K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 151 | $13K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 29 | $10K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 116 | $358K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 151 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 151 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.