| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| RELPH ROBERT G AGENCY INC3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $180K | $22K | $202K | 4.15% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | DELTA DENTAL OF NEW YORK, INC. | $10K | — | $10K | 3.05% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | $7K | — | $7K | 7.12% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $3K | $4K | $6K | 11.23% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $8K | $4K | $12K | 22.69% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $2K | $2K | 4.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | COMPANION LIFE INSURANCE COMPANY | $5K | $951 | $6K | 14.99% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $3K | $2K | $5K | 23.03% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $414 | $414 | 2.00% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | MUTUAL OF OMAHA INSURANCE COMPANY | $827 | $160 | $987 | 14.92% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $0 | — | $0 | — |
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 | 857 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 857 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 834 | $4.9M |
| Dental | DELTA DENTAL OF NEW YORK, INC. | 615 | $331K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 625 | $57K |
| Life insurance(3 contracts, 2 carriers) | COMPANION LIFE INSURANCE COMPANY | 838 | $59K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 152 | $54K |
| Long-term disability | LIBERTY LIFE ASSURANCE COMPANY OF BOSTON | 857 | $93K |
| Other(4 contracts, 3 carriers) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 2,407 | $31K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,407 | — |
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.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.