| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | P.O. BOX 948 HENRIETTA, NY 14467 | BLUECROSS BLUESHIELD | $46K | — | $46K | 4.86% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY INC | 9810 E 42ND STREET SUITE 100 TULSA, OK 74146 | DELTA DENTAL | $5K | $11K | $17K | 12.25% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 146204648 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $6K | $738 | $6K | 17.00% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENGY INC | P.O. BOX 948 HENRIETTA, NY 144670948 | VISION SERVICE PLAN | $1K | — | $1K | 4.45% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 146204648 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $390 | $4K | 16.85% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 146204648 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $507 | $4K | 17.48% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 146204648 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $3K | $357 | $3K | 17.12% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY | 150 SAWGRASS DRIVE ROCHESTER, NY 146204648 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $2K | $441 | $2K | 18.25% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 150 SAWGRASS DRIVE ROCHESTER, NY 146204648 | UNITED OF OMAHA LIFE INSURANCE COMPANY | $1K | $253 | $1K | 18.12% |
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 | 317 | 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) | 317 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUECROSS BLUESHIELD | 317 | $950K |
| Dental | DELTA DENTAL | 228 | $137K |
| Vision | VISION SERVICE PLAN | 217 | $33K |
| Life insurance(3 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 214 | $51K |
| Short-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $35K |
| Long-term disability(2 contracts) | UNITED OF OMAHA LIFE INSURANCE COMPANY | 149 | $50K |
| Other | UNITED OF OMAHA LIFE INSURANCE COMPANY | 54 | $8K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 317 | — |
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.
Premium per covered life exceeds 2× the peer median for this NAICS + size cohort. Either richly-funded plan or struggling with a bad rate.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.