| 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 | EMPIRE HEALTHCHOICE ASSURANCE INC | $75K | — | $75K | 6.90% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $7K | $7K | $14K | 7.45% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | $2K | $678 | $3K | 13.24% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | — | $953 | $953 | 4.04% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $893 | $3K | 12.84% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $3K | $162 | $3K | 14.72% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | $2K | $1K | $4K | 22.67% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN ROAD SOLON, OH 44139 | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | — | $630 | $630 | 4.00% |
| ROBERT G. RELPH AGENCY, INC.3 | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | — | — | $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 | 661 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 661 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EMPIRE HEALTHCHOICE ASSURANCE INC | 347 | $1.1M |
| Dental | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 345 | $192K |
| Vision | GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 345 | $192K |
| Life insurance(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | 661 | $44K |
| Short-term disability | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 89 | $16K |
| Long-term disability(2 contracts, 2 carriers) | LINCOLN LIFE & ANNUITY COMPANY OF NEW YORK | 55 | $21K |
| Other(2 contracts, 2 carriers) | DEARBORN NATIONAL LIFE INSURANCE COMPANY OF NEW YORK | 661 | $44K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 661 | — |
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."
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.
Schedule A presence shifted between filings (insured ↔ self-funded, or new contracts added/removed). Capture the transition window.