| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | UNITED HEALTHCARE INSURANCE COMPANY | $8K | — | $8K | 3.14% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | COMPANION LIFE INSURANCE COMPANY | $7K | — | $7K | 5.00% |
| 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 | $2K | $2K | $4K | 21.48% |
| FCE BENEFIT ADMINISTRATORS, INC.5 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | EYEMED | $402 | — | $402 | 2.50% |
| 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 | $396 | $377 | $773 | 21.47% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 PLAN SERVICE PROVIDER | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | $179K |
| USI INSURANCE SERVICES NTL, INC. EIN 56-1882208 PLAN SERVICE PROVIDER | Insurance agents and brokers Service code 22 | 5901 PRIESTLY DR 309 CARLSBAD, CA 92008 | $21K |
| TRUST MANAGEMENT SERVICES, INC. EIN 46-3922133 PLAN SERVICE PROVIDER | Accounting (including auditing); Trustee (directed) Service code 10 | 1 ALMADEN BLVD, STE 620 SAN JOSE, CA 95113 | $17K |
| CLIFTONLARSONALLEN LLP EIN 41-0746749 PLAN SERVICE PROVIDER | Accounting (including auditing) Service code 10 | 925 HIGHLAND POINTE DRIVE, STE 450 ROSEVILLE, CA 95678 | $15K |
| FIRST HEALTH INC. EIN 20-1736437 PLAN SERVICE PROVIDER | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | 3200 HIGHLAND AVE DOWNERS GROVE, IL 60515 | $6K |
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 | 225 | 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) | 225 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITED HEALTHCARE INSURANCE COMPANY | 242 | $465K |
| Dental | COMPANION LIFE INSURANCE COMPANY | 242 | $209K |
| Vision | EYEMED | 242 | $16K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 163 | $17K |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 242 | $209K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE COMPANY | 95 | $51K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 58 | $142K |
| Other(3 contracts, 3 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 225 | $7K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 242 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.