| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| FBP INSURANCE SERVICES3 | 130 THEORY, STE 200 IRVINE, CA 926173065 | VISION SERVICE PLAN | $4K | — | $4K | 4.58% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $4K | $4K | $9K | 9.79% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $9K | $4K | $13K | 14.68% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $8K | $4K | $12K | 14.98% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | 648 VILLAGE PARK DR UNIT 208 WILMINGTON, NC 28405 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $6K | $861 | $7K | 12.42% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD STE G GREENSBORO, NC 27409 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $4K | $34 | $4K | 7.41% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE ROAD, STE 206 ROSWELL, GA 30075 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $2K | — | $2K | 3.19% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $1 | $1K | 2.46% |
| CHARLES D. BLOCK3 Filed as: CHARLES D BLOCK | UNIT 208 648 VILLAGE PARK DR WILMINGTON, NC 28405 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $3K | $262 | $3K | 8.55% |
| F.B.P. INSURANCE SERVICES, LLC3 | 414 GALLIMORE DAIRY ROAD SUITE F GREENSBORO, NC 27409 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $2K | — | $2K | 5.67% |
| CUSTOM BENEFIT PROGRAMS INC3 Filed as: CUSTOM BENEFIT PROGRAMS | 897 12TH ST HAMMONTON, NJ 08037 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $734 | $503 | $1K | 3.42% |
| JAMES H. VAN EPPS3 Filed as: JAMES VAN EPPS | 10930 CRABAPPLE RD, STE 206 ROSWELL, GA 30075 | PROVIDENT LIFE AND ACCIDENT INSURANCE COMPANY | $1K | — | $1K | 2.82% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $1K | $747 | $2K | 13.79% |
| F.B.P. INSURANCE SERVICES, LLC3 | 130 THEORY STREET, SUITE 200 IRVINE, CA 92612 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $459 | $459 | $918 | 9.86% |
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 | 843 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 846 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS OF CALIFORNIA | 1,079 | $4.9M |
| Dental | AETNA LIFE INSURANCE CO. | 227 | $41K |
| Vision | VISION SERVICE PLAN | 423 | $92K |
| Life insurance(3 contracts, 2 carriers) | LIFE INSURANCE COMPANY OF NORTH AMERICA | 843 | $204K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 843 | $87K |
| Other(3 contracts, 2 carriers) | UNUM LIFE INSURANCE COMPANY OF AMERICA | 843 | $81K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,079 | — |
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.