| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK, INC. | 45 EAST AVENUE # 700 ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS BLUE SHIELD | $52K | — | $52K | 4.01% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 1133 WESTCHESTER AVE STE N136 WEST HARRISON, NY 10604 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $5K | $7K | $12K | 8.88% |
| TITAN INS & EMPLOYEE BENEFITS3 | 610 CLINTON SQ ROCHESTER, NY 14604 | COMPANION LIFE INSURANCE COMPANY | $3K | $2K | $5K | 14.47% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | — | $3K | 10.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $2K | $2K | 5.81% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $1K | $1K | 4.25% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | — | $2K | 10.00% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $1K | $1K | 7.38% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $980 | $980 | 5.82% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 14604 | COMPANION LIFE INSURANCE COMPANY | $1K | — | $1K | 10.00% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DR ROCHESTER, NY 14620 | COMPANION LIFE INSURANCE COMPANY | — | $1K | $1K | 9.68% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA, INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | COMPANION LIFE INSURANCE COMPANY | — | $759 | $759 | 5.92% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $257 | — | $257 | 10.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $152 | $152 | 5.93% |
| PAYCHEX INSURANCE AGENCY, INC.5 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $1K | $1K | 46.63% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NEW YORK INC | 45 EAST AVE ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $223 | — | $223 | 10.02% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN INS AGENCY OF VA INC | 11220 ASSETT LOOP STE 304 MANASSAS, VA 20109 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $151 | $151 | 6.78% |
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 | 218 | 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) | 218 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 128 | $1.3M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 165 | $140K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 165 | $140K |
| Life insurance | MUTUAL OF OMAHA INSURANCE COMPANY | 218 | $3K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 218 | $29K |
| Long-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 218 | $17K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 128 | $1.3M |
| Other(5 contracts, 3 carriers) | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 218 | $189K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 218 | — |
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 compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.