| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DR ROCHESTER, NY 14620 | HEALTH OPTIONS | $52K | — | $52K | 4.33% |
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 33758 | HEALTH OPTIONS | $17K | — | $17K | 1.42% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DR ROCHESTER, NY 14620 | BLUE CROSS BLUE SHIELD OF FLORIDA | $25K | — | $25K | 3.63% |
| ROGER BOUCHARD INSURANCE INC3 | PO BOX 6090 CLEARWATER, FL 33758 | BLUE CROSS BLUE SHIELD OF FLORIDA | $13K | — | $13K | 1.92% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY, INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | FLORIDA COMBINED LIFE | $4K | — | $4K | 10.28% |
| FLORIDA BLUE3 Filed as: FAISON, SHANA - FLORIDA BLUE | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | FLORIDA COMBINED LIFE | $81 | — | $81 | 0.22% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY, INC | 150 SAWGRASS DR ROCHESTER, NY 14620 | FLORIDA COMBINED LIFE | $2K | — | $2K | 8.71% |
| ROGERS BENEFIT GROUP INC3 | 4300 W CYPRESS ST STE 210 TAMPA, FL 33607 | FLORIDA COMBINED LIFE | $152 | — | $152 | 0.72% |
| FLORIDA BLUE3 Filed as: FAISON, SHANA - FLORIDA BLUE | 4800 DEERWOOD CAMPUS PKWY # DC2/2 JACKSONVILLE, FL 32246 | FLORIDA COMBINED LIFE | $52 | — | $52 | 0.25% |
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 | 401 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 0 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 403 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | HEALTH OPTIONS | 180 | $1.9M |
| Dental(4 contracts, 3 carriers) | HEALTH OPTIONS | 210 | $1.9M |
| Vision(2 contracts, 2 carriers) | HEALTH OPTIONS | 180 | $1.9M |
| Prescription drug(2 contracts, 2 carriers) | HEALTH OPTIONS | 180 | $1.9M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 210 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.