| 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 STE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE IMSURANCE COMPANY | $7K | $8K | $14K | 2.10% |
| BENEFITSTORE INC3 | 100 BENEFIT FOCUS WAY CHARLESTON, SC 29492 | METROPOLITAN LIFE IMSURANCE COMPANY | — | $5K | $5K | 0.74% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | STANDARD OF NEW YORK | $8K | — | $8K | 3.79% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | STANDARD OF NEW YORK | $8K | — | $8K | 5.90% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | AETNA LIFE INSURANCE CO | $16K | — | $16K | 17.42% |
| MERCER HEALTH AND BENEFITS, LLC3 Filed as: MERCER HEALTH BENEFITS | 4565 PAYSPHERE CIRCLE CHICAGO, IL 60674 | EYEMED (FIDELITY SECURITY LIFE INSURANCE CO OF NEW YORK) | $529 | — | $529 | 1.24% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | FOUR EVER LIFE INSURANCE CO | $302 | — | $302 | 5.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | NATIONAL UNION FIRE INS. CO. OF PITTSBURGH PA | $190 | — | $190 | 25.00% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| AETNA LIFE INSURANCE COMPANY EIN 06-6033492 CONTRACT ADMIN | Contract Administrator Service code 13 | — | $621K |
| TELUS HEALTH (US) LTD EIN 52-1883918 EAP ADMIN | Contract Administrator Service code 13 | — | $11K |
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 | 842 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 842 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | FOUR EVER LIFE INSURANCE CO | 873 | $6K |
| Dental | METROPOLITAN LIFE IMSURANCE COMPANY | 1,103 | $669K |
| Vision | EYEMED (FIDELITY SECURITY LIFE INSURANCE CO OF NEW YORK) | 1,066 | $43K |
| Life insurance | STANDARD OF NEW YORK | 842 | $142K |
| Long-term disability | STANDARD OF NEW YORK | 462 | $206K |
| Other(3 contracts, 3 carriers) | STANDARD OF NEW YORK | 842 | $235K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 1,103 | — |
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.
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.