| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.5 Filed as: ROBERT G RELPH AGENCY INC. | 800 PARKER HILL DR SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUECROSS BLUESHIELD | $85K | — | $85K | 3.00% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC. | 400 WILLOW BROOK OFFICE PARK SUITE 40 FAIRPORT, NY 14450 | COMPANION LIFE INSURANCE COMPANY | $5K | $3K | $8K | 9.60% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | COMPANION LIFE INSURANCE COMPANY | — | $2K | $2K | 2.50% |
| ROBERT G. RELPH AGENCY, INC.5 Filed as: ROBERT G RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK STE 40 FAIRPORT, NY 14450 | MUTUAL OF OMAHA INSURANCE COMPANY | $3K | $1K | $5K | 14.11% |
| NATIONAL BENEFIT CENTER3 | 6830 COCHRAN RD SOLON, OH 44139 | MUTUAL OF OMAHA INSURANCE COMPANY | — | $946 | $946 | 2.74% |
| RELPH ROBERT G AGENCY INC5 | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $2K | $2K | $5K | 14.20% |
| EBPA, LLC5 | PO BOX 2365 SOUTH BURLINGTON, VT 054072365 | EBPA, LLC | — | $13K | $13K | — |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH BENEFIT ADVISORS | 400 WILLOWBROOK OFFICE PARK SUITE 400 FAIRPORT, NY 14450 | EBPA, LLC | — | $4K | $4K | — |
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 | 482 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 482 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUECROSS BLUESHIELD | 302 | $2.8M |
| Dental | EBPA, LLC | 335 | $0 |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 277 | $32K |
| Life insurance | COMPANION LIFE INSURANCE COMPANY | 337 | $82K |
| Short-term disability | MUTUAL OF OMAHA INSURANCE COMPANY | 413 | $35K |
| Prescription drug | EXCELLUS BLUECROSS BLUESHIELD | 302 | $2.8M |
| Other | MUTUAL OF OMAHA INSURANCE COMPANY | 413 | $35K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 413 | — |
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.