| 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 | KAISER FOUNDATION HEALTH PLAN INC. | $60K | $5K | $65K | 5.03% |
| FCE BENEFIT ADMINISTRATORS, INC.5 | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | MADISON NATIONAL LIFE INSURANCE COMPANY | — | — | $0 | 0.00% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $539 | $2K | $3K | 47.56% |
| FCE BENEFIT ADMINISTRATORS, INC.3 Filed as: FCE BENEFIT ADMINISTRATORS | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | RELIANCE STANDARD LIFE INSURANCE COMPANY | $90 | $321 | $411 | 45.67% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| FCE BENEFIT ADMINISTRATORS, INC. EIN 33-0330036 PLAN SERVICE PROVIDER | Plan Administrator; Recordkeeping and information management (computing, tabulating, data processing, etc.) Service code 14 | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | $113K |
| FCE BENEFIT ADMINISTRATORS EIN 33-0330036 PARTY IN INTEREST | Recordkeeping and information management (computing, tabulating, data processing, etc.); Contract Administrator Service code 13 | 1528 SOUTH EL CAMINO REAL, STE 307 SAN MATEO, CA 94402 | $36K |
| GALLINA LLP EIN 94-2147510 PLAN SERVICE PROVIDER | Accounting (including auditing) Service code 10 | 2870 GOLD TAILINGS COURT RANCHO CORDOVA, CA 95670 | $23K |
| TRUST MANAGEMENT SERVICES EIN 46-3922133 PLAN SERVICE PROVIDER | Accounting (including auditing); Trustee (directed) Service code 10 | 1 ALMADEN BLVD, SUITE 950 SAN JOSE, CA 95113 | $18K |
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 | 0 | 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) | 0 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | KAISER FOUNDATION HEALTH PLAN INC. | 212 | $1.3M |
| Dental | MADISON NATIONAL LIFE INSURANCE COMPANY | 121 | $102K |
| Life insurance | RELIANCE STANDARD LIFE INSURANCE COMPANY | 266 | $5K |
| Other | RELIANCE STANDARD LIFE INSURANCE COMPANY | 266 | $900 |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 266 | — |
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.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.