| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 4615 WALZEM RD, SUITE 300 SAN ANTONIO, TX 78218 | UNITEDHEALTHCARE INSURANCE COMPANY | $50K | $0 | $50K | 5.95% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 13784 NEWARK, NJ 07188 | SUN LIFE ASSURANCE COMPANY OF CANADA | $1K | $0 | $1K | 7.92% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | 1 KELLY WAY SPARKS, MD 21152 | SUN LIFE ASSURANCE COMPANY OF CANADA | $363 | $0 | $363 | 2.08% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON INS SERV WEST | 525 MARKET STREET, SUITE 3400 SAN FRANCISCO, CA 94105 | SUN LIFE ASSURANCE COMPANY OF CANADA | $0 | $90 | $90 | 0.52% |
| WILLIS TOWERS WATSON US LLC3 Filed as: WILLIS TOWERS WATSON SOUTHEAST | PO BOX 13784 NEWARK, NJ 07188 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $215 | $27 | $242 | 8.44% |
| KELLY & ASSOCIATES INSURANCE GROUP3 | ONE KELLY WAY SPARKS, MD 21152 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $72 | — | $72 | 2.51% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $267 | $392 | $659 | 24.99% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $0 | $49 | $49 | 10.89% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 S. EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94409 | RELANCE STANDARD LIFE INSURANCE COMPANY | $49 | $47 | $96 | 29.54% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 PLAN SERVICE PROVIDER | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 1528 S EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | $78K |
| WILLIS TOWERS WATSON SOUTHEAST, INC EIN 62-1404453 PLAN SERVICE PROVIDER | Contract Administrator; Participant communication Service code 13 | 12505 PARK POTOMAC AVE STE 300 POTOMAC, MD 20854 | $56K |
| CLIFTONLARSONALLEN, LLP EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | 925 HIGHLAND POINTE DRIVE, STE 450 ROSEVILLE, CA 95678 | $21K |
| TRUST MANAGEMENT SERVICES EIN 46-3922133 PLAN SERVICE PROVIDER | Trustee (directed); Accounting (including auditing) Service code 10 | 1 ALMADEN BLVD, STE 620 SAN JOSE, CA 95113 | $11K |
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 | 36 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 0 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 36 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 32 | $843K |
| Dental | SUN LIFE ASSURANCE COMPANY OF CANADA | 32 | $17K |
| Vision | NATIONAL GUARDIAN LIFE INSURANCE COMPANY | 38 | $8K |
| Life insurance(2 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 65 | $6K |
| Long-term disability | RELANCE STANDARD LIFE INSURANCE COMPANY | 3 | $325 |
| Other(3 contracts, 3 carriers) | UNITED BEHAVIORAL HEALTH DBA OPTUM | 190 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 190 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.