| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX AGENCY, INC. | 150 SAWGRASS DR ROCHESTER, NY 146204648 | KAISER FOUNDATION HEALTH PLAN INC | $12K | $3 | $12K | 1.97% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 225 KENNETH DR ROCHESTER, NY 14623 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | — | $7K | 8.30% |
| REUBEN WARNER ASSOCIATES, INC.3 Filed as: WARNER PACIFIC INSURANCE SERVICE | 32110 AGOURA DR WEST LAKE VILLAGE, CA 91361 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | — | $3K | 4.11% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC | 20829 72ND AVE S STE 400 KENT, WA 98032 | KAISER FOUNDATION HEALTH PLAN OF WASHINGTON | $4K | — | $4K | 5.62% |
| PAYCHEX INSURANCE AGENCY, INC.3 Filed as: PAYCHEX INSURANCE AGENCY INC. | 225 KENNETH DR ROCHESTER, NY 14620 | KAISER FOUNDATION HEALTH PLAN OF THE NORTHWEST | $2K | $38 | $2K | 3.10% |
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 | 107 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 107 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 110 | $718K |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $82K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $82K |
| Life insurance | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $82K |
| Prescription drug(3 contracts, 3 carriers) | KAISER FOUNDATION HEALTH PLAN INC | 110 | $718K |
| Other | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 107 | $82K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 110 | — |
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."
No prospect flags tripped on this filing.