| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| HP PLANNING LLC3 | 535 CONNECTICUT AVE STE 502 NORWALK, CT 06854 | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | $67K | $272 | $67K | 3.69% |
| MARSH & MCLENNAN AGENCY LLC3 Filed as: MARSH & MCCLENNAN AGENCY LLC | 101 HUNTINGTON AVE STE 401 BOSTON, MA 02199 | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | $9 | $0 | $9 | 0.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $112 | $0 | $112 | 0.94% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | LIFE INSURANCE COMPANY OF NORTH AMERICA | -$196 | $0 | -$196 | -1.66% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $69 | $0 | $69 | 0.71% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 CONSHOHOCKEN, NY 19428 | LIFE INSURANCE COMPANY OF NORTH AMERICA | $17 | $0 | $17 | 0.87% |
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 | 142 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 3 | Continuation coverage (COBRA, retiree health). |
| Retired/separated still eligible | 47 | Vested but not currently using benefits. |
| Total participants (= "Plan participants" tile) | 192 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 219 | $1.8M |
| Dental | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 219 | $1.8M |
| Vision | EYEMED VISION CARE ON BEHALF OF FIDELITY SECURITY LIFE INSURANCE CO. | 135 | $14K |
| Life insurance | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $10K |
| Short-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $12K |
| Long-term disability | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $12K |
| Prescription drug | BLUE CROSS BLUE SHIELD OF MASSACHUSETTS, INC. | 219 | $1.8M |
| Other | LIFE INSURANCE COMPANY OF NORTH AMERICA | 145 | $2K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 219 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.