| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | EXCELLUS BLUE CROSS BLUE SHIELD | $28K | — | $28K | 1.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS INC - NY | 45 EAST AVENUE #700 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $27K | — | $27K | 1.26% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES | 100 MERIDIAN CENTER BOULEVARD SUITE 100 ROCHESTER, NY 14618 | EXCELLUS BLUE CROSS BLUE SHIELD | $26K | — | $26K | 1.23% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 2850 GOLF ROAD, 5TH FLOOR ROLLING MEADOWS, IL 60008 | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | $3K | $4K | $7K | 3.72% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | PO BOX 948 HENRIETTA, NY 14467 | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | $7K | — | $7K | 3.66% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 500 PLUM ST SYRACUSE, NY 13204 | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | $5K | — | $5K | 2.44% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 3009 ARLINGTON HEIGHTS, IL 60006 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | $869 | $3K | 3.18% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | 225 KENNETH DRIVE ROCHESTER, IL 14623 | METROPOLITAN LIFE INSURANCE COMPANY | $1K | — | $1K | 1.21% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | PO BOX 95287 CHICAGO, IL 60694 | METROPOLITAN LIFE INSURANCE COMPANY | — | $4 | $4 | 0.00% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | 225 KENNETH DRIVE ROCHESTER, NY 14623 | METROPOLITAN LIFE INSURANCE COMPANY | $2K | — | $2K | 10.00% |
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 | 239 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 1 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 240 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 149 | $2.1M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 273 | $105K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 255 | $17K |
| Life insurance | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 239 | $187K |
| Short-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 239 | $187K |
| Long-term disability | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 239 | $187K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 149 | $2.1M |
| Other | SUN LIFE AND HEALTH INSURANCE COMPANY U.S. | 239 | $187K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 273 | — |
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.