| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | BLUE CROSS BLUE SHIELD OF FLORIDA | $15K | — | $15K | 4.00% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 4.65% |
| UNKNOWN3 | UNKNOWN ORCHARD PARK, NY 14127 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | — | $3K | $3K | 2.21% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 300 CORPORAATE POINT, SUITE 150 CULVER CITY, CA 90230 | MVP HEALTH CARE | $6K | — | $6K | 4.28% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | BLUECROSS BLUESHIELD OF WESTERN NEW YORK | $450 | — | $450 | 0.67% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $7K | $1K | $9K | 19.27% |
| BB&T INSURANCE SERVICES, INC.3 Filed as: M AND T INSURANCE AGENCY, INC. | 285 DELAWARE AVENUE, SUITE 4000 BUFFALO, NY 14202 | FIRST UNUM LIFE INSURANCE COMPANY | $250 | $67 | $317 | 0.70% |
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 | 215 | 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) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 68 | $775K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $152K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 189 | $152K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 146 | $45K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 146 | $45K |
| Prescription drug(4 contracts, 4 carriers) | BLUE CROSS BLUE SHIELD OF FLORIDA | 68 | $775K |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 146 | $45K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 189 | — |
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.