| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | EXCELLUS BLUE CROSS BLUE SHIELD | $68K | — | $68K | 3.49% |
| TITAN INS & EMPLOYEE BENEFITS3 Filed as: TITAN INS. DBA US EMPL BEN SERV GR | 1 SOUTH CLINTON ROCHESTER, NY 14604 | EXCELLUS BLUE CROSS BLUE SHIELD | $8K | — | $8K | 0.41% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $2K | $3K | $5K | 3.50% |
| TITAN INS & EMPLOYEE BENEFITS3 Filed as: TITAN INSURANCE DBA USEBSG | 1 SOUTH CLINTON ROCHESTER, NY 14604 | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | $728 | $273 | $1K | 0.70% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | FIRST UNUM LIFE INSURANCE COMPANY | $8K | $4K | $12K | 10.80% |
| TITAN INS & EMPLOYEE BENEFITS3 Filed as: TITAN INSURANCE DBA USEBSG | 1 SOUTH CLINTON ROCHESTER, NY 14604 | FIRST UNUM LIFE INSURANCE COMPANY | $1K | $242 | $2K | 1.39% |
| PAYCHEX INSURANCE AGENCY, INC.3 | 150 SAWGRASS DRIVE ROCHESTER, NY 14620 | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. NY | $2K | — | $2K | 10.78% |
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 | 269 | 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) | 269 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 172 | $2.0M |
| Dental | PROVIDENT LIFE AND CASUALTY INSURANCE COMPANY | 188 | $143K |
| Vision | EYEMED VISION CARE ON BEHALF OF THE FIDELITY SECURITY LIFE INS. CO. NY | 248 | $20K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 269 | $111K |
| Short-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 269 | $111K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 269 | $111K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 172 | $2.0M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 269 | $111K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 269 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.