| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $53 | $53 | 0.03% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS INC | 1828 S EL CAMINO REAL SAN MATEO, CA 94402 | VSP | $1K | — | $1K | 3.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| CBIZ BENEFITS & INSURANCE SERVICES, PLAN SERVICE PROVIDERR | Contract Administrator Service code 13 | 175 S MAIN STE 720 SALT LAKE CITY, UT 84101 | $74K |
| FCE BENEFIT ADMINISTRATORS, INC EIN 33-0330036 PLAN SERVICE PROVIDER | Contract Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 13 | — | $41K |
| CLIFTONLARSONALLEN, LLC EIN 41-0746749 NONE | Accounting (including auditing) Service code 10 | — | $25K |
| TRUST MANAGEMENT SERVICES EIN 46-3922133 PLAN SERVICE PROVIDER | Trustee (directed); Accounting (including auditing) Service code 10 | — | $17K |
| COMPSYCH EIN 35-3739783 NONE | Contract Administrator Service code 13 | — | $0 |
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 | 559 | 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) | 559 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Dental | DELTA DENTAL OF NORTH CAROLINA | 471 | $91K |
| Vision | VSP | 296 | $38K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 540 | $187K |
| Short-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 540 | $187K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 540 | $187K |
| Other | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 540 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 540 | — |
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.