| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $20K | — | $20K | 5.00% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 EL CAMINO REAL STE. 407 SAN MATEO, CA 94422 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $2K | — | $2K | 6.14% |
| FCE BENEFIT ADMINISTRATORS, INC.5 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $2K | $2K | 11.71% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | — | $2K | 11.00% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 15.00% |
| FCE BENEFIT ADMINISTRATORS, INC.5 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | METROPOLITAN LIFE INSURANCE COMPANY | — | $306 | $306 | 2.08% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC. | 1528 S EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $905 | — | $905 | 9.23% |
| FCE BENEFIT ADMINISTRATORS, INC.5 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $327 | $327 | 11.72% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $307 | — | $307 | 11.00% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 1528 EL CAMINO REAL STE. 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $445 | $445 | 21.69% |
| FORREST T JONES AND COMPANY, INC5 Filed as: FORREST T. JONES | 3130 BROADWAY KANSAS CITY, MO 641112406 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $222 | $222 | 10.82% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 EL CAMINO REAL STE. 407 SAN MATO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $103 | — | $103 | 5.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 NONE | Contract Administrator; Claims processing; Other insurance fees and expenses; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 12 | 1528 S EL CAMINO REAL, STE. 407 SAN MATEO, CA 94402 | $193K |
| CIGNA HEALTH AND LIFE INSURANCE COM EIN 59-1031071 NONE | Other services Service code 49 | PO BOX 645014 CINCINNATI, OH 452645014 | $27K |
| FIDUCIARY PLAN MANAGEMENT SERVICES EIN 46-3922133 NONE | Trustee (directed); Accounting (including auditing) Service code 10 | 1 ALAMADEN BLVD, STE 620 SAN JOSE, CA 95113 | $21K |
| BUSINESS BENEFTIS GROUP EIN 54-1769053 NONE | Consulting (general) Service code 16 | 4069 CHAIN BRIDGE RD FAIRFAX, VA 22030 | $19K |
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 | 138 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 138 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 123 | $35K |
| Vision | FIDELITY SECURITY LIFE INSURANCE COMPANY | 135 | $10K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 147 | $16K |
| Short-term disability | METROPOLITAN LIFE INSURANCE COMPANY | 144 | $15K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 4 | $2K |
| Stop-loss / reinsurancereinsurance | FIDELITY SECURITY LIFE INSURANCE COMPANY | 116 | $406K |
| Other(2 contracts, 2 carriers) | FIDELITY SECURITY LIFE INSURANCE COMPANY | 147 | $36K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 147 | — |
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.