| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC | 45 EAST AVENUE ROCHESTER, NY 14604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $70K | — | $70K | 3.34% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC. | 45 EAST AVENUE ROCHESTER, NY 14604 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $51K | — | $51K | 3.79% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC | 45 EAST AVENUE ROCHESTER, NY 14604 | MVP HEALTH CARE | $23K | — | $23K | 5.96% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC | 45 EAST AVENUE ROCHESTER, NY 14604 | COMPANION LIFE INSURANCE COMPANY | $6K | — | $6K | 13.50% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC | 45 EAST AVENUE ROCHESTER, NY 14604 | MUTUAL OF OMAHA INSURANCE COMPANY | $4K | — | $4K | 9.91% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC | 45 EAST AVENUE ROCHESTER, NY 14604 | COMPANION LIFE INSURANCE COMPANY | $4K | — | $4K | 14.00% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN & BROWN OF NY, INC | 45 EAST AVENUE ROCHESTER, NY 14604 | MVP HEALTH CARE | $550 | — | $550 | 4.19% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 CONTRACT ADMINISTRATOR | Claims processing Service code 12 | 165 COURT STREET ROCHESTER, NY 14647 | $4.5M |
| BROWN & BROWN OF NY, INC BROKER | Insurance agents and brokers Service code 22 | 45 EAST AVENUE ROCHESTER, NY 14604 | $0 |
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 | 12,937 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 12,937 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(4 contracts, 2 carriers) | EXCELLUS BLUECROSS BLUESHIELD | 142 | $879K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 499 | $74K |
| Long-term disability(2 contracts, 2 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 11,218 | $1.4M |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUE CROSS BLUE SHIELD | 8,930 | $854K |
| Other(3 contracts, 3 carriers) | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 12,428 | $2.3M |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 12,428 | — |
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.