| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.3 | 887 MITTEN RD STE 200 BURLINGAME, CA 94010 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $2K | $2K | $4K | 21.16% |
| FCE BENEFIT ADMINISTRATORS, INC.5 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | EYEMED | $266 | — | $266 | 2.50% |
| FCE BENEFIT ADMINISTRATORS, INC.3 | 887 MITTEN RD STE 200 BURLINGAME, CA 94010 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $394 | $358 | $752 | 20.98% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 PLAN SERVICE PROVIDER | Claims processing; Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator; Other services Service code 12 | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | $112K |
| TRUST MANAGEMENT SERVICES EIN 46-3922133 PLAN SERVICE PROVIDER | Trustee (directed); Accounting (including auditing) Service code 10 | 1 ALMADEN BLVD, STE 620 SAN JOSE, CA 95113 | $11K |
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 | 125 | 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) | 125 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | COMPANION LIFE INSURANCE COMPANY | 127 | $328K |
| Dental | COMPANION LIFE INSURANCE COMPANY | 127 | $328K |
| Vision | EYEMED | 127 | $11K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 63 | $21K |
| Short-term disability | COMPANION LIFE INSURANCE COMPANY | 127 | $328K |
| Prescription drug | FIDELITY SECURITY LIFE INSURANCE | 222 | $31K |
| Other(2 contracts, 2 carriers) | RELIANCE STANDARD LIFE INSURANCE COMPANY | 128 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 222 | — |
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.