| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC, | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $3K | — | $3K | 7.45% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRVE SUITE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $4K | — | $4K | 11.22% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $289 | — | $289 | 1.03% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $4K | $1K | $5K | 19.96% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 12.94% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $399 | — | $399 | 12.93% |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH ROBERT G. AGENCY INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | HARTFORD LIFE INSURANCE COMPANY | $113 | — | $113 | 15.07% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| THE GUARDIAN LIFE INSURANCE COMPANY EIN 13-5123390 CLAIMS PROCESSING | Claims processing Service code 12 | — | $14K |
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 | 242 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 242 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | INDEPENDENT HEALTH BENEFITS CORPORATION | 48 | $376K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 184 | $25K |
| Life insurance(2 contracts) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 245 | $36K |
| Short-term disability(2 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 245 | $45K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 245 | $34K |
| Other | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 245 | $3K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 245 | — |
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."
The primary carrier changed from prior filing. The plan is already willing to move; opportunity to re-pitch on the next cycle.