| Broker | Address | Carrier | Commissions | Fees | Total comp | % of premium |
|---|---|---|---|---|---|---|
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC. | 800 PARKER HILL DRIVE SUITE 100 ROCHESTER, NY 14625 | EXCELLUS BLUE CROSS BLUE SHIELD | $19K | — | $19K | 7.08% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY, INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | EXCELLUS BLUECROSS BLUESHIELD | $18K | — | $18K | 13.50% |
| GCG FINANCIAL LLC3 Filed as: ALERA GROUP INC | 3 PARKWAY NORTH STE 500 DEERFIELD, IL 60015 | THE GUARDIAN LIFE INSURANCE COMPANY | — | $18K | $18K | 23.04% |
| ROBERT G. RELPH AGENCY, INC.3 Filed as: ROBERT G RELPH AGENCY INC | 800 PARKER HILL DRIVE STE 100 ROCHESTER, NY 14625 | THE GUARDIAN LIFE INSURANCE COMPANY | $3K | — | $3K | 4.05% |
| Provider | Services | Address | Compensation |
|---|---|---|---|
| EXCELLUS BLUECROSS BLUESHIELD EIN 15-0329043 THIRD PARTY ADMINISTRATOR | Claims processing Service code 12 | — | $338K |
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 | 801 | Currently employed and enrolled or eligible. |
| Total participants (= "Plan participants" tile) | 801 | Active + retired/separated + beneficiaries. No dependents. |
| Coverage | Top carrier | Persons covered EOY | Premium |
|---|---|---|---|
| Health (medical) | EXCELLUS BLUE CROSS BLUE SHIELD | 128 | $270K |
| Vision | THE GUARDIAN LIFE INSURANCE COMPANY | 732 | $77K |
| Prescription drug | EXCELLUS BLUE CROSS BLUE SHIELD | 128 | $270K |
| Stop-loss / reinsurancereinsurance | EXCELLUS BLUECROSS BLUESHIELD | 822 | $136K |
| Other | EMPLOYEE SERVICES, INC. (ESI GROUP) | 801 | $21K |
| Persons covered (= "Persons covered" tile) | Max across the rows above | 822 | — |
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.