| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 225 KENNETH DRIVE ROCHESTER, NY 14623 | BLUE CROSS BLUE SHIELD OF ARIZONA | $17K | $0 | $17K | 2.88% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 225 KENNETH DRIVE ROCHESTER, GA 14623 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $2K | $0 | $2K | 14.68% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 225 KENNETH DRIVE ROCHESTER, GA 14623 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $996 | $0 | $996 | 14.74% |
| BLUE CROSS BLUE SHIELD OF FLORIDA3 Filed as: BCBS OF ARIZONA | UNKNOWN PHOENIX, AZ 85021 | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | $0 | $332 | $332 | 4.91% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 225 KENNETH DRIVE ROCHESTER, GA 14623 | PRINCIPAL LIFE INSURANCE COMPANY | $928 | $29 | $957 | 19.77% |
| CENTRO BENEFITS RESEARCH LLC3 Filed as: CENTRO BENEFITS RESEARCH, LLC | 200 GALLERIA PARKWAY, SUITE 1950 ATLANTA, GA 30339 | PRINCIPAL LIFE INSURANCE COMPANY | $0 | $24 | $24 | 0.50% |
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 | 152 | 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) | 152 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF ARIZONA | 169 | $573K |
| Dental | BLUE CROSS BLUE SHIELD OF ARIZONA | 169 | $573K |
| Life insurance(2 contracts) | EQUITABLE FINANCIAL LIFE INSURANCE COMPANY OF AMERICA | 152 | $21K |
| Other | PRINCIPAL LIFE INSURANCE COMPANY | 33 | $5K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 169 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.