| 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 DR STE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $71K | — | $71K | 3.67% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $6K | — | $6K | 8.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $4K | — | $4K | 7.13% |
| MARISSA TARBY3 | 37 UNION ST AUBURN, NY 13021 | AFLAC | $794 | $42 | $836 | 5.29% |
| LAURA ANNE CALARCO3 | 340 HORSE CREEK DR APT 208 NAPLES, FL 34110 | AFLAC | $456 | — | $456 | 2.88% |
| NICHOLAS CALARCO3 | 120 E WASHINGTON ST STE 822 SYRACUSE, NY 13202 | AFLAC | $426 | $6 | $432 | 2.73% |
| JOSEPH P CALARCO3 | PO BOX 130 AUBURN, NY 13021 | AFLAC | $317 | $6 | $323 | 2.04% |
| DEBRA M PARKER3 Filed as: DEBRA PARKER | 20 BOWEN ST AUBURN, NY 13021 | AFLAC | $144 | — | $144 | 0.91% |
| SUZANNE GOULD3 | 2741 SAND BEACH RD AUBURN, NY 13021 | AFLAC | $72 | — | $72 | 0.46% |
| KIM ANNE FLOOD3 | 731 OLD MEDFORD AVE MEDFORD, NY 11763 | AFLAC | $48 | — | $48 | 0.30% |
| JOHN B INFERRERA3 | 174 GARNSEY RD PITTSFORD, NY 14534 | AFLAC | $33 | — | $33 | 0.21% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | AFLAC | $29 | — | $29 | 0.18% |
| KARL L FONDA3 | 311 BROOKSBORO DR WEBSTER, NY 14580 | AFLAC | $20 | — | $20 | 0.13% |
| FALCONE ASSOCIATES3 Filed as: FALCONE ASSOCIATES INC | 901 LODI ST SYRACUSE, NY 13203 | AFLAC | $17 | — | $17 | 0.11% |
| JEFFREY R DALABA3 | 8500 GILLY FLOWER CT BALDWINSVILLE, NY 13027 | AFLAC | $17 | — | $17 | 0.11% |
| PATRICK R RUHLE3 | 200 GARDEN CITY PLAZA STE 410 GARDEN CITY, NY 11530 | AFLAC | $15 | — | $15 | 0.09% |
| MICHELE L WILLIAMS3 | 12650 55TH RD N W PALM BEACH, FL 33411 | AFLAC | $13 | — | $13 | 0.08% |
| TERESA STRONG3 | 1070 SKATES ST THE VILLAGES, FL 32163 | AFLAC | $12 | — | $12 | 0.08% |
| BRAD JONES AND ASSOCIATES INC3 | 19 BRITISH AMERICAN BLVD W LATHAM, NY 12110 | AFLAC | $11 | — | $11 | 0.07% |
| CHARLES L GRAY3 | 3122 MARIAS DR FORT WAYNE, IN 46815 | AFLAC | $10 | — | $10 | 0.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $2K | — | $2K | 15.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | EYEMED VISION CARE | $802 | — | $802 | 9.13% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DR STE 100 ROCHESTER, NY 14625 | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | $1K | — | $1K | 15.00% |
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 | 232 | Currently employed and enrolled or eligible. |
| Retired/separated still receiving benefits | 2 | Continuation coverage (COBRA, retiree health). |
| Total participants (= "Plan participants" tile) | 234 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 177 | $1.9M |
| Dental | EXCELLUS BLUE CROSS BLUE SHIELD | 185 | $76K |
| Vision | EYEMED VISION CARE | 82 | $9K |
| Life insurance | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 154 | $55K |
| Short-term disability(2 contracts, 2 carriers) | AFLAC | 228 | $24K |
| Long-term disability | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 154 | $15K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 177 | $1.9M |
| Other(3 contracts, 2 carriers) | NEW YORK LIFE GROUP INSURANCE COMPANY OF NEW YORK | 228 | $79K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 228 | — |
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."
Top carrier holds >85% of premium. If that carrier hits a rate increase, the entire plan moves.