| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94402 | FIDLEITY SECURITY LIFE INSURANCE COMPANY | $5K | — | $5K | 2.42% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 S EL CAMINO REAL, STE 407 SAN MATEO, CA 90442 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $692 | — | $692 | 4.93% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 4615 WALZEM ROAD SUITE 300 SAN ANTONIO, TX 78218 | EYEMED VISON CARE ON BE. OF FIDELITY SECURITY LIFE INSURANCE COMPANY | $525 | — | $525 | 8.43% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 S EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $644 | $586 | $1K | 21.00% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 S EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94402 | FIDELITY SECURITY LIFE INSURANCE COMPANY | $61 | $266 | $327 | 26.63% |
| FORREST T JONES AND COMPANY, INC3 Filed as: FORREST JONES | 3130 BROADWAY KANSAS CITY, MO 64111 | FIDELITY SECURITY LIFE INSURANCE COMPANY | — | $133 | $133 | 10.83% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 S EL CAMINO REAL SUITE 407 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $110 | $100 | $210 | 21.02% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS INC EIN 33-0330036 NONE | Other services; Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 12 | — | $122K |
| CIGNA CORPORATION EIN 59-1031071 NONE | Claims processing Service code 12 | — | $14K |
| TRUST MANAGEMENT SERVICES, INC EIN 46-3922133 NONE | Trustee (bank, trust company, or similar financial institution) Service code 21 | — | $14K |
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 | 407 | 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) | 407 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS BLUE SHIELD OF TEXAS | 15 | $83K |
| Vision | EYEMED VISON CARE ON BE. OF FIDELITY SECURITY LIFE INSURANCE COMPANY | 206 | $6K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 57 | $6K |
| Short-term disability(2 contracts, 2 carriers) | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 57 | $6K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 9 | $1K |
| Stop-loss / reinsurancereinsurance | FIDLEITY SECURITY LIFE INSURANCE COMPANY | 139 | $218K |
| Other | COLONIAL LIFE & ACCIDENT INSURANCE COMPANY | 24 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 206 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.