| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BLUE CROSS BLUE SHIELD OF ARIZONA | 2444 W. LAS PALMARITAS DR. PHOENIX, AZ 85021 | EQUITIBLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | — | $15K | $15K | 5.03% |
| USI INSURANCE SERVICES LLC3 Filed as: USI INSURANCE SERVICES INC | 2375 E. CAMELBACK RD., SUITE 250 PHOENIX, AZ 85016 | EQUITIBLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $8K | — | $8K | 2.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 1528 S. EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94402 | $302K |
| FIDUCIARY PLAN MANAGEMENT SERVICES EIN 46-3922133 NONE | Accounting (including auditing); Trustee (directed) Service code 10 | 1 ALAMADEN BLVD., SUITE 750 SAN JOSE, CA 95113 | $31K |
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 | 1,686 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 1,686 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | EQUITIBLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 1,760 | $340K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 597 | $25K |
| Life insurance | EQUITIBLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 1,114 | $293K |
| Short-term disability | EQUITIBLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 1,114 | $293K |
| Other | EQUITIBLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 1,114 | $293K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,760 | — |
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.