| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS | 4615 WALZEM ROAD, SUITE 300 SAN ANTONIO, TX 78218 | UNITEDHEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 2.95% |
| 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 | $875 | — | $875 | 10.00% |
| 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 | $1K | — | $1K | 15.01% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINSITRATORS, INC | 4615 WALZEM ROAD, SUITE 300 SAN ANTONIO, TX 78218 | EYEMED VISION CARE ON BEHALF FIDELITY SECURITY LIFE INSURANCE COMPANY | $498 | — | $498 | 9.40% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS EIN 33-0330036 NONE | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services; Claims processing Service code 12 | 1528 S EL CAMINO REAL, SUITE 407 SAN MATEO, CA 94402 | $56K |
| TRUST MANAGEMENT SERVICES EIN 46-3922133 NONE | Accounting (including auditing); Trustee (bank, trust company, or similar financial institution) Service code 10 | A ALMADEN BLVD, SUITE 620 SAN JOSE, CA 95113 | $13K |
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 | 151 | 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) | 151 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | UNITEDHEALTHCARE INSURANCE COMPANY | 27 | $266K |
| Vision | EYEMED VISION CARE ON BEHALF FIDELITY SECURITY LIFE INSURANCE COMPANY | 81 | $5K |
| Life insurance(2 contracts) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 68 | $17K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 81 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.