| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS | 45 EAST AVENUE # 700 ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS BLUE SHIELD | $74K | — | $74K | 3.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS | 45 EAST AVENUE # 700 ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS BLUE SHIELD | $30K | — | $30K | 4.36% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 45 EAST AVENUE ROCHESTER, NY 14604 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | $10K | — | $10K | 5.96% |
| IMG5 | 2960 NORTH MERIDIAN STREET INDIANAPOLIS, IN 46208 | PRUDENTIAL INSURANCE COMPANY OF AMERICA | — | $70 | $70 | 0.04% |
| AON CONSULTING INC3 | 30 WATERSIDE DR FARMINGTON, CT 06034 | THE PAUL REVERE LIFE INSURANCE COMPANY | $2K | — | $2K | 5.94% |
| SMOLA CONSULTING, LLC3 Filed as: SMOLA CONSULTING LLC | 260 EAST MAIN ST ROCHESTER, NY 14614 | THE PAUL REVERE LIFE INSURANCE COMPANY | $900 | — | $900 | 2.27% |
| ANTHONY R MANGIONE3 | 29 SISSON DR ROCHESTER, NY 14623 | THE PAUL REVERE LIFE INSURANCE COMPANY | $605 | $18 | $623 | 1.57% |
| GALLAGHER BENEFIT SERVICES, INC.3 Filed as: GALLAGHER BENEFIT SERVICES INC | 100 MERIDIAN CENTRE BLVD ROCHESTER, NY 14618 | THE PAUL REVERE LIFE INSURANCE COMPANY | $215 | — | $215 | 0.54% |
| BERT VAN DER WERFF3 | PO BOX 43 ANNSVILLE, NY 13308 | THE PAUL REVERE LIFE INSURANCE COMPANY | $58 | $2 | $60 | 0.15% |
| STEPHEN JOSEPH JOYCE3 | 33 GATES CIR APT 2D BUFFALO, NY 14209 | THE PAUL REVERE LIFE INSURANCE COMPANY | $56 | — | $56 | 0.14% |
| GARY KAMINSKA3 | 32123 EAST AVE APT E ROCHESTER, NY 14510 | THE PAUL REVERE LIFE INSURANCE COMPANY | $47 | — | $47 | 0.12% |
| FOUR POINTS INC3 | 8049 BARONY WOODS PITTSFORD, NY 14534 | THE PAUL REVERE LIFE INSURANCE COMPANY | $31 | — | $31 | 0.08% |
| KARL L FONDA3 | 311 BROOKSBORO DR WEBSTER, NY 14580 | THE PAUL REVERE LIFE INSURANCE COMPANY | $8 | — | $8 | 0.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS | 45 EAST AVENUE # 700 ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS BLUE SHIELD | $1K | — | $1K | 4.35% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INSURANCE SERVICES | 45 EAST AVE ROCHESTER, NY 14604 | METROPOLITAN LIFE INSURANCE COMPANY | $3K | $198 | $3K | 9.23% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK INC | 6 TOWER PL ALBANY, NY 12203 | METROPOLITAN LIFE INSURANCE COMPANY | — | $226 | $226 | 0.74% |
| SMOLA CONSULTING, LLC3 Filed as: SMOLA CONSULTING LLC | 260 E MAIN ST STE 2400 ROCHESTER, NY 14604 | METROPOLITAN LIFE INSURANCE COMPANY | $216 | — | $216 | 0.71% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS SVCS | 45 EAST AVE #700 ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS BLUE SHIELD | $907 | — | $907 | 4.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN | — | METROPOLITAN LIFE INSURANCE COMPANY | $3K | — | $3K | 15.00% |
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 | 806 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 480 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 1,286 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts) | EXCELLUS BLUE CROSS BLUE SHIELD | 161 | $2.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 495 | $161K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 426 | $19K |
| Life insurance | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 806 | $164K |
| Short-term disability | THE PAUL REVERE LIFE INSURANCE COMPANY | 52 | $40K |
| Long-term disability | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 806 | $164K |
| Prescription drug(4 contracts) | EXCELLUS BLUE CROSS BLUE SHIELD | 161 | $2.9M |
| Other(3 contracts, 3 carriers) | PRUDENTIAL INSURANCE COMPANY OF AMERICA | 806 | $234K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 806 | — |
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."
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.