| 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 | BLUESHIELD OF NORTHEASTERN NEW YORK | $69K | — | $69K | 3.37% |
| RELPH ROBERT G AGENCY INC3 | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $6K | $9K | $15K | 8.05% |
| NATIONAL BENEFIT CENTER3 Filed as: NATIONAL BENEFIT CENTER LLC | 1105 NORTH MARKET STREET SUITE 1300 WILMINGTON, DE 19801 | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | $188 | — | $188 | 0.10% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $10K | $840 | $11K | 16.25% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G. RELPH AGENCY INC | 400 WILLOWBROOK OFFICE PARK STE 400 FAIRPORT, NY 14450 | FIRST UNUM LIFE INSURANCE COMPANY | $4K | $480 | $4K | 11.32% |
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 | 215 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 215 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | BLUESHIELD OF NORTHEASTERN NEW YORK | 301 | $2.0M |
| Dental | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $183K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY OF AMERICA | 215 | $183K |
| Life insurance | FIRST UNUM LIFE INSURANCE COMPANY | 140 | $67K |
| Long-term disability | FIRST UNUM LIFE INSURANCE COMPANY | 58 | $38K |
| Prescription drug | BLUESHIELD OF NORTHEASTERN NEW YORK | 301 | $2.0M |
| Other | FIRST UNUM LIFE INSURANCE COMPANY | 140 | $67K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 301 | — |
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.