| 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 | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | $62K | — | $62K | 3.31% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | METROPOLITAN LIFE INSURANCE COMPANY | $6K | $2K | $8K | 4.97% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $4K | $1K | $5K | 12.00% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | COMPANION LIFE INSURANCE COMPANY | — | $875 | $875 | 2.18% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $2K | $942 | $3K | 13.84% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $628 | $628 | 2.56% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | COMPANION LIFE INSURANCE COMPANY | $2K | $1K | $3K | 14.41% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | COMPANION LIFE INSURANCE COMPANY | — | $692 | $692 | 2.94% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $727 | $727 | 3.71% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $485 | $485 | 2.47% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $1K | $391 | $2K | 13.25% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $261 | $261 | 2.17% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $806 | $317 | $1K | 13.94% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR SUITE 350 BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $211 | $211 | 2.62% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | MUTUAL OF OMAHA INSURANCE COMPANY | $178 | $81 | $259 | 14.53% |
| NATIONAL BENEFIT CENTER3 | 3700 PARK EAST DR STE 350 BEACHWOOD, OH 44122 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $54 | $54 | 3.03% |
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 | 367 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 367 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | HIGHMARK WESTERN AND NORTHEASTERN NEW YORK INC | 272 | $1.9M |
| Dental | METROPOLITAN LIFE INSURANCE COMPANY | 609 | $170K |
| Vision | METROPOLITAN LIFE INSURANCE COMPANY | 609 | $170K |
| Life insurance(2 contracts) | COMPANION LIFE INSURANCE COMPANY | 367 | $64K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 110 | $20K |
| Long-term disability(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 71 | $37K |
| Other(2 contracts) | MUTUAL OF OMAHA INSURANCE COMPANY | 367 | $10K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 609 | — |
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.