| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | METROPOLITAN LIFE INSURANCE COMPANY | $12K | $60 | $12K | 0.80% |
| BROWN AND BROWN OF FLORIDA, INC.3 Filed as: BROWN AND BROWN OF NEW YORK INC. | DBA ROWLANDS BARRANCA AG 6 TOWER PL ALBANY, NY 12203 | METROPOLITAN LIFE INSURANCE COMPANY | $297 | $1K | $1K | 0.10% |
| MICHAEL STEPNOWSKI3 | EMPLOYEE FAMILY PROTECTION 90 KRIEGER LANE GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $14K | $21K | $35K | 4.75% |
| MICHAEL STEPNOWSKI3 | EMPLOYEE FAMILY PROTECTION INC P O BOX 1237 90 KREIGER LANE GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $36K | $12K | $48K | 9.87% |
| MICHAEL STEPNOWSKI3 | EMPLOYEE FAMILY PROTECTION INC P O BOX 1237 90 KREIGER LANE GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $29K | $8K | $38K | 12.14% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | DAVIS VISION | $4K | — | $4K | 1.74% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | MVP HEALTH CARE | $6K | — | $6K | 4.71% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | BLUESHIELD OF NORTHEASTERN NEW YORK | $740 | — | $740 | 1.03% |
| MICHAEL STEPNOWSKI3 | EMPLOYEE FAMILY PROTECTION, INC. P O BOX 1237, 90 KREIGER LANE GLASTONBURY, CT 06033 | FIRST UNUM LIFE INSURANCE COMPANY | $8K | $1K | $9K | 19.33% |
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 | 3,676 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 3,676 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | CAPITAL DISTRICT PHYSICIAN'S HEALTH PLAN, INC. | 2,650 | $724K |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 3,476 | $1.4M |
| Vision | DAVIS VISION | 2,726 | $229K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 2,196 | $491K |
| Short-term disability(2 contracts) | FIRST UNUM LIFE INSURANCE COMPANY | 1,943 | $781K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 772 | $312K |
| Prescription drug(2 contracts) | BLUESHIELD OF NORTHEASTERN NEW YORK | 32 | $95K |
| Stop-loss / reinsurancereinsurance | HM LIFE INSURANCE COMPANY OF NEW YORK | 1,459 | $477K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 3,476 | — |
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.