| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC.5 | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | COMPANION LIFE INSURANCE COMPANY | $29K | — | $29K | 5.00% |
| FCE BENEFIT ADMINISTRATORS, INC.5 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | COMPANION LIFE INSURANCE COMPANY | $770 | — | $770 | 2.09% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 1528 SOUTH EL CAMINO REAL, STE 407 SAN MATEO, CA 94402 | EYEMED | $410 | — | $410 | 2.50% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS, INC | 887 MITTEN RD STE 200 BURLINGAME, CA 94010 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $769 | $699 | $1K | 21.00% |
| 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 | $199K |
| CIGNA HEALTH AND LIFE INSURANCE EIN 59-1031071 PLAN SERVICE PROVIDER | Claims processing; Insurance services Service code 12 | 400 NORTH BRAND BLVD. STE 300 GLENDALE, CA 91203 | $45K |
| NFP - THE MELTZER GROUP EIN 22-3811325 PLAN SERVICE PROVIDER | Consulting (general) Service code 16 | 6500 ROCK SPRING DRIVE BETHESDA, MD 20817 | $36K |
| TRUST MANAGEMENT SERVICES PLAN SERVICE PROVIDER | Trustee (directed); Accounting (including auditing) Service code 10 | 1 ALMADEN BLVD, STE 620 SAN JOSE, CA 95113 | $30K |
| GLOBAL CARE EIN 31-1407689 PLAN SERVICE PROVIDER | Insurance services; Claims processing Service code 12 | PO BOX 43856 ATLANTA, GA 30374 | $15K |
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 | 234 | 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) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | COMPANION LIFE INSURANCE COMPANY | 134 | $37K |
| Vision | EYEMED | 126 | $16K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 227 | $7K |
| Stop-loss / reinsurancereinsurance | COMPANION LIFE INSURANCE COMPANY | 171 | $590K |
| Other | MAGELLAN HEALTHCARE | 228 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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.