| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FBP INSURANCE SERVICES3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92617 | AETNA LIFE INSURANCE COMPANY | — | $4K | $4K | 0.94% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 926173065 | VISION SERVICE PLAN | $4K | — | $4K | 5.00% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $5K | $12K | 15.88% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $3K | $5K | $8K | 10.89% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $7K | $5K | $11K | 15.44% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $673 | $2K | 4.62% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | $135 | $1K | 3.51% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.91% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | $39 | $2K | 7.56% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD STE G GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $59 | $2K | 5.71% |
| BLOCK, CHARLES, D3 | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $932 | $131 | $1K | 4.00% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $954 | $2K | 14.72% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $345 | $481 | $826 | 10.90% |
No Schedule C service providers reported on this filing.
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 | 753 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 11 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 764 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | BLUE CROSS OF CALIFORNIA | 566 | $4.6M |
| Dental | AETNA LIFE INSURANCE COMPANY | 1,122 | $434K |
| Vision | VISION SERVICE PLAN | 393 | $83K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 720 | $182K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 720 | $72K |
| Other(4 contracts, 3 carriers) | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | 720 | $86K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,122 | — |
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."
Broker comp is under 1% of premium on a >$1M plan. Plan may be flying solo or paying a flat fee — consultant sales target.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.