| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PASRKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $50K | — | $50K | 7.42% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING, INC. | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | EMPIRE HEALTHCHOICE ASSURANCE, INC. | $9K | $25K | $34K | 5.06% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $33K | — | $33K | 8.11% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING, INC. | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $6K | $17K | $23K | 5.82% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $33K | — | $33K | 8.11% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING, INC. | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | $6K | $17K | $23K | 5.77% |
| FNA INSURANCE SERVICES INC3 Filed as: FNA INSURANCE SERVICES, INC. | 1000 WOODBURY ROAD SUITE 403 WOODBURY, NY 11797 | UNITEDHEALTHCARE INSURANCE COMPANY | $90 | — | $90 | 0.03% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING, INC. | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | UNITEDHEALTHCARE INSURANCE COMPANY | -$69 | — | -$69 | -0.02% |
| RELPH ROBERT G AGENCY INC3 Filed as: RELPH BENEFIT ADVISORS | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $7K | — | $7K | 4.61% |
| MARSHALL & STERLING EMPLOYEE BENEFI3 Filed as: MARSHALL & STERLING, INC. | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | CIGNA HEALTH AND LIFE INSURANCE COMPANY | $4K | — | $4K | 2.56% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EMPIRE HEALTHCHOICE ASSURANCE, INC. EIN 23-7391136 THIRD PARTY ADMINISTRATOR | Float revenue; Other services; Recordkeeping and information management (computing, tabulating, data processing, etc.); Claims processing; Contract Administrator Service code 12 | — | $649K |
| MARSHALL & STERLING, INC. THIRD PARTY ADMINISTRATOR | Other commissions; Insurance brokerage commissions and fees; Insurance agents and brokers Service code 22 | 110 MAIN STREET POUGHKEEPSIE, NY 12601 | $0 |
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 | 2,099 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 2,099 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical)(2 contracts, 2 carriers) | UNITEDHEALTHCARE INSURANCE COMPANY | 35 | $512K |
| Dental | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 905 | $677K |
| Life insurance(2 contracts) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 2,099 | $803K |
| Short-term disability | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 2,099 | $401K |
| Long-term disability(2 contracts) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 2,099 | $803K |
| Stop-loss / reinsurancereinsurance | EMPIRE HEALTHCHOICE ASSURANCE, INC. | 905 | $677K |
| Other(4 contracts, 3 carriers) | ANTHEM LIFE & DISABILITY INSURANCE COMPANY | 2,099 | $983K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 2,099 | — |
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."
Primary broker changed. Recently changed advisors; vulnerable to a second-look pitch or hostile takeover.
Broker compensation exceeds 5% of premium. Either a small-plan minimum-fee dynamic or an inefficient broker structure ripe for a counter-bid.