| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FBP INSURANCE SERVICES3 | 130 THEORY ST, STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $16K | $11K | $27K | 17.00% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST, STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $11K | $7K | $18K | 16.96% |
| FBP INSURANCE SERVICES3 | 130 THEORY STREET SUITE 200 IRVINE, CA 926173065 | VISION SERVICE PLAN | $5K | — | $5K | 5.34% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST, STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $2K | $9K | 12.30% |
| FBP INSURANCE SERVICES3 | 130 THEORY ST, STE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $2K | $6K | 16.17% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $416 | $8 | $424 | 7.84% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD, STE F GREENSOBOR, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $189 | — | $189 | 3.49% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH STREET HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $118 | $86 | $204 | 4.15% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD, STE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $178 | — | $178 | 3.62% |
| WADE ROBERT OLSON3 Filed as: WADE R OLSON | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $16 | — | $16 | 0.33% |
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 | 497 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 23 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 520 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1,318 | $6.0M |
| Dental | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 497 | $716K |
| Vision | VISION SERVICE PLAN | 462 | $99K |
| Life insurance(3 contracts, 3 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 497 | $880K |
| Short-term disability(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 497 | $787K |
| Long-term disability(2 contracts, 2 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 497 | $823K |
| Other(4 contracts, 4 carriers) | CIGNA HEALTH AND LIFE INSURANCE COMPANY AND AFFILIATES | 497 | $767K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,318 | — |
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 comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.