| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | SIRIUS AMERICA INSURANCE COMPANY | $14K | — | $14K | 5.00% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 528 SOUTH EL CAMINO REAL SUITE 307 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $199 | — | $199 | 10.99% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 528 SOUTH EL CAMINO REAL SUITE 307 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $181 | $181 | 9.99% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 528 SOUTH EL CAMINO REAL SUITE 307 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $14 | — | $14 | 11.29% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 528 SOUTH EL CAMINO REAL SUITE 307 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | — | $12 | $12 | 9.68% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 NONE | Other insurance fees and expenses; Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing Service code 12 | 1528 SOUTH EL CAMINO REAL SUITE 307 SAN MATEO, CA 94402 | $152K |
| GLOBAL CARE, INC. EIN 31-1407689 NONE | Other services Service code 49 | 2 CONCOURSE PKWY NE SUITE 300 ATLANTA, GA 30328 | $28K |
| WILLIS OF MARYLAND EIN 52-0559369 NONE | Contract Administrator; Participant communication Service code 13 | 225 SCHILLING CIRCLE, STE. 150 HUNT VALLEY, MD 21023 | $21K |
| CIGNA HEALTH AND LIFE INSURANCCE EIN 59-1031071 NONE | Other services Service code 49 | PO BOX 645014 CINCINNATI, OH 452645014 | $15K |
| FIDUCIARY PLAN MANAGEMENT SERVICES EIN 46-3922133 NONE | Accounting (including auditing); Trustee (directed) Service code 10 | 1 ALMADEN BLVD, STE. 620 SAN JOSE, CA 95113 | $10K |
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 | 562 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 562 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INSURANCE COMPANY | 140 | $33K |
| Vision | COMPANION LIFE INSURANCE COMPANY | 140 | $33K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 142 | $2K |
| Stop-loss / reinsurancereinsurance | SIRIUS AMERICA INSURANCE COMPANY | 80 | $281K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 142 | $124 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 142 | — |
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.