| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | UNITEDHEALTHCARE INSURANCE COMPANY | $20K | $0 | $20K | 5.25% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 702 KING FARM BOULEVARD, SUITE 210 ROCKVILLE, MD 20850 | UNITEDHEALTHCARE INSURANCE COMPANY | $5K | $0 | $5K | 1.28% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $3K | $3K | 4.53% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 911 PANORAMA TRAIL SOUTH SUITE 100 ROCHESTER, NY 14625 | STARMOUNT LIFE INSURANCE COMPANY | $3K | $21 | $3K | 3.81% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | STARMOUNT LIFE INSURANCE COMPANY | $847 | $0 | $847 | 1.10% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | STARMOUNT LIFE INSURANCE COMPANY | $0 | $212 | $212 | 0.28% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 225 KENNETH DRIVE ROCHESTER, NY 14623 | KAISER FOUNDATION HEALTH PLAN OF THE MID-ATLANTIC STATES, INC. | $2K | $945 | $3K | 5.88% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 911 PANORAMA TRAIL SOUTH SUITE 100 ROCHESTER, NY 14625 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $1K | $413 | $2K | 6.10% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $2K | $2K | 5.32% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 15800 CRABBS BRANCH WAY, SUITE 350 ROCKVILLE, MD 20855 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $100 | $0 | $100 | 0.35% |
| GALLAGHER BENEFIT SERVICES, INC.3 | 2850 GOLF ROAD, 11TH FLOOR ROLLING MEADOWS, IL 60008 | UNUM LIFE INSURANCE COMPANY OF AMERICA | $0 | $25 | $25 | 0.09% |
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 | 52 | 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) | 52 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 68 | $435K |
| Dental | STARMOUNT LIFE INSURANCE COMPANY | 105 | $77K |
| Vision | STARMOUNT LIFE INSURANCE COMPANY | 105 | $77K |
| Short-term disability | UNUM LIFE INSURANCE COMPANY OF AMERICA | 52 | $28K |
| Prescription drug(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 68 | $435K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 105 | — |
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.